Evidence map›Paper›PMID 30402916›Full record

ArticleBritish journal of clinical pharmacology2019

Predictors of first-year nonadherence and discontinuation of statins among older adults: a retrospective cohort study.

Richard Ofori-Asenso, Jenni Ilomäki, Mark Tacey, Si Si, Andrea J Curtis, Ella Zomer, J Simon Bell, Sophia Zoungas, Danny Liew

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in British journal of clinical pharmacology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Impact of Interventions on Medication Adherence in Patients With Coexisting Diabetes and Hypertension.Health expectations : an international journal of public participation in health care and health policy · 2024
    Pooled it
  2. Prevalence of statin intolerance: a meta-analysis.European heart journal · 2022 · on this map
    Pooled it
  3. Pooled it
  4. Review
  5. Article
  6. Association between Exposure to Statin Choice and Adherence to Statins: An Observational Cohort Study.Medical decision making : an international journal of the Society for Medical Decision Making · 2025
    Observational
  7. Article
  8. Review
  9. Trajectories of oral bisphosphonate use after hip fractures: a population-based cohort study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024
    Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Persistence and Adherence to Cardiovascular Medicines in Australia.Journal of the American Heart Association · 2023
    Article
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  17. Observational
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Richard Ofori-AsensoCentre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.ORCID 0000-0002-6643-3269
Jenni IlomäkiCentre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.
Mark TaceyCentre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
Si SiCentre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.ORCID 0000-0002-2406-7221
Andrea J CurtisDivision of Metabolism, Ageing and Genomics, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
Ella ZomerCentre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
J Simon BellCentre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.
Sophia ZoungasDivision of Metabolism, Ageing and Genomics, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
Danny LiewCentre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsThe aim of this study was to examine the level of and predictors of statin nonadherence and discontinuation among older adults.

methodsAmong 22 340 Australians aged ≥65 years who initiated statin therapy from January 2014 to December 2015, we estimated the first-year nonadherence (proportion of days covered [PDC] <0.80) and discontinuation (≥90 days without statin coverage) rates. Predictors of nonadherence and discontinuation were examined via multivariable logistic regression. Analyses were performed separately for general beneficiaries (with a higher co-payment; n = 4841) and concessional beneficiaries (with a lower co-payment; n = 17 499).

resultsDuring the one-year follow-up, 55.1% were nonadherent (concessional 52.6%; general beneficiaries 64.2%) and 44.7% discontinued statins (concessional 43.1%; general beneficiaries 50.4%). Among concessional beneficiaries, those aged 75-84 years and ≥85 years were more likely to discontinue than people aged 65-74 years (odds ratio 1.11, 95% confidence interval 1.04-1.19 and 1.38, 1.23-1.54, respectively). Diabetes was associated with an increased likelihood of nonadherence and discontinuation, while hypertension, angina and congestive heart failure were associated with a lower likelihood of nonadherence and discontinuation. Anxiety was associated with an increased likelihood of discontinuation, but polypharmacy (concurrent use of five or more drugs) was associated with a lower likelihood of nonadherence and discontinuation. Statin initiation by a general medical practitioner was associated with both increased likelihood of nonadherence and discontinuation. Similar predictors of nonadherence and discontinuation were identified for the general beneficiaries.

conclusionsAmong older adults prescribed statins, first-year nonadherence and discontinuation are high. Specific population subgroups such as people aged ≥85 years, those with diabetes or anxiety may require additional attention to improve statin adherence.

Indexed as

Drug MonitoringAgedAged, 80 and overAnxietyAustraliaCardiovascular DiseasesComorbidityDiabetes MellitusDrug PrescriptionsFees, PharmaceuticalFemaleFollow-Up StudiesHealth ExpendituresHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleHydroxymethylglutaryl-CoA Reductase Inhibitorsdiscontinuationnonadherenceolder adultspersistencestatins

Identifiers

PMID30402916
PMCPMC6303220

What OpenQuestion holds

Texttitle and abstract
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.