Evidence map›Paper›PMID 30913959›Full record

ArticleJournal of the American Heart Association2019

Patient-Reported Reasons for Declining or Discontinuing Statin Therapy: Insights From the PALM Registry.

Corey K Bradley, Tracy Y Wang, Shuang Li, Jennifer G Robinson, Veronique L Roger, Anne C Goldberg, Salim S Virani, Michael J Louie, L Veronica Lee, Eric D Peterson and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Heart Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 145 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
145citing papers in PubMed, 8 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

145 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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  6. Prevalence of statin intolerance: a meta-analysis.European heart journal · 2022 · on this map
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  16. Bempedoic Acid: From Guidelines to the Real World.Journal of lipid and atherosclerosis · 2026
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85 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Corey K Bradley1 Department of Medicine and Duke Clinical Research Institute Duke University School of Medicine Durham NC.
Tracy Y Wang1 Department of Medicine and Duke Clinical Research Institute Duke University School of Medicine Durham NC.
Shuang Li1 Department of Medicine and Duke Clinical Research Institute Duke University School of Medicine Durham NC.
Jennifer G Robinson2 Department of Epidemiology College of Public Health University of Iowa Iowa City IA.
Veronique L Roger3 Department of Internal Medicine Division of Cardiovascular Diseases Mayo Clinic Rochester MN.
Anne C Goldberg4 Washington University St Louis MO.
Salim S Virani5 Department of Medicine Baylor College of Medicine Houston TX.
Michael J Louie6 Global Medical Affairs Regeneron Pharmaceuticals, Inc. Tarrytown NY.
L Veronica Lee7 Sanofi Pharmaceuticals Bridgewater NJ.
Eric D Peterson1 Department of Medicine and Duke Clinical Research Institute Duke University School of Medicine Durham NC.
Ann Marie Navar1 Department of Medicine and Duke Clinical Research Institute Duke University School of Medicine Durham NC.

Funding

Preventing Cardiovascular Disease through Improved Risk Prediction and CommunicationK01HL133416 · NHLBI · DUKE UNIVERSITY · PI NAVAR, ANN MARIE · 2016 to 2020
$707k
NHLBI NIH HHS K01 HL133416
6 · The paper itself

Abstract

Background Many adults eligible for statin therapy for cardiovascular disease prevention are untreated. Our objective was to investigate patient-reported reasons for statin underutilization, including noninitiation, refusal, and discontinuation. Methods and Results This study included the 5693 adults recommended for statin therapy in the PALM (Patient and Provider Assessment of Lipid Management) registry. Patient surveys evaluated statin experience, reasons for declining or discontinuing statins, and beliefs about statins and cardiovascular disease risk. Overall, 1511 of 5693 adults (26.5%) were not on treatment. Of those not on a statin, 894 (59.2%) reported never being offered a statin, 153 (10.1%) declined a statin, and 464 (30.7%) had discontinued therapy. Women (relative risk: 1.22), black adults (relative risk: 1.48), and those without insurance (relative risk: 1.38) were most likely to report never being offered a statin. Fear of side effects and perceived side effects were the most common reasons cited for declining or discontinuing a statin. Compared with statin users, those who declined or discontinued statins were less likely to believe statins are safe (70.4% of current users vs. 36.9% of those who declined and 37.4% of those who discontinued) or effective (86.3%, 67.4%, and 69.1%, respectively). Willingness to take a statin was high; 67.7% of those never offered and 59.7% of patients who discontinued a statin would consider initiating or retrying a statin. Conclusions More than half of patients eligible for statin therapy but not on treatment reported never being offered one by their doctor. Concern about side effects was the leading reason for statin refusal or discontinuation. Many patients were willing to reconsider statin therapy if offered.

Indexed as

Attitude to HealthMedication AdherenceMotivationTreatment RefusalAdultAgedAtherosclerosisBlack or African AmericanCardiovascular DiseasesDrug-Related Side Effects and Adverse ReactionsFearFemaleHealthcare DisparitiesHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleHydroxymethylglutaryl-CoA Reductase Inhibitorscardiovascular disease preventionpatient education/teachingstatin therapy

Identifiers

PMID30913959
PMCPMC6509731

What OpenQuestion holds

Texttitle and abstract
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.