Evidence map›Paper›PMID 8604188›Full record

ArticleThe Medical journal of Australia1996

Apparent discontinuation rates in patients prescribed lipid-lowering drugs.

L A Simons, G Levis, J Simons

Registry-linked trialAbstract read
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In one paragraph

Article in The Medical journal of Australia, 1996. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01770210 (A Multicenter, Open-label, 30-week Observational Clinical Study to Examine the Progress of Patients After Leaving the Cardiology Clinic or Unit Due to Acute Cardiovascular Event.), which is not on this map. Cited by 51 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
51citing 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.

NCT01770210 completedstarted 2013, after this paper: background citation

A Multicenter, Open-label, 30-week Observational Clinical Study to Examine the Progress of Patients After Leaving the Cardiology Clinic or Unit Due to Acute Cardiovascular Event.

Ran2013Enrolled670Registered outcomes6Posted comparisons0ConditionsCardiovascular DisordersArmsPatients on atorvastatin treatment
PMID 20425272PMID 12132975PMID 12132976PMID 12181210PMID 12505111PMID 15883224PMID 19367148PMID 11966668PMID 9416884PMID 9851392PMID 11914253other papers from this trial
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3 · Its place in the literature

Who cites it

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

  1. Pooled it
  2. Prevalence of statin intolerance: a meta-analysis.European heart journal · 2022 · on this map
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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

3 authors.

L A SimonsUniversity of New South Wales Lipid Research Department, St Vincent's Hospital, Sydney.
G Levis
J Simons

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate apparent discontinuation rates in patients newly prescribed lipid-lowering drugs. DESIGN AND

settingA prospective survey of 12 months' dispensing data in 138 community pharmacies across metropolitan Sydney. PATIENTS: 610 adults (49% men) with a mean age of 58 years; 91% of prescriptions were from general practitioners; prescribed drugs were simvastatin (54%), pravastatin (31%) and gemfibrozil (15%).

main outcome measureThe number of patients failing to collect prescription refills.

results60% of patients (95% confidence interval [CI], 56%-64%) apparently discontinued their medication over 12 months. Half of the apparent discontinuations occurred within three months and a quarter within one month of starting treatment. The predominant reasons for discontinuation were: patient unconvinced about need for treatment (32%), poor efficacy (32%) and adverse events (7%). Only half of those experiencing poor efficacy were switched to another drug. The relative risk (RR) of discontinuation was lower in older patients (age 65+ v. <50 years: RR 0.66; 95% CI 0.47-0.93) and in those using other cardiovascular drugs (RR 0.69; CI 0.56-0.86), but was increased in those showing early evidence of poor compliance (RR 1.77; CI 1.33-2.35). Discontinuation appeared to be unrelated to sex, the source of the prescription (general practitioner or specialist), past use of lipid-lowering drugs or the cost of medication.

conclusionsHigh apparent discontinuation rates with lipid-lowering drugs suggest significant wastage of resources in treatments that are initiated but not continued and a lost opportunity for heart disease prevention. Many patients appear to discontinue therapy for illogical reasons and this may be amenable to intervention.

Indexed as

Treatment RefusalAgedCommunity Pharmacy ServicesDrug UtilizationFemaleHumansHypolipidemic AgentsMaleMiddle AgedMultivariate AnalysisNew South WalesPractice Patterns, Physicians'Product Surveillance, PostmarketingProspective StudiesUrban HealthHypolipidemic Agents

Identifiers

PMID8604188

What OpenQuestion holds

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Registered trials

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.