Statin persistence and adherence among older initiators: A nationwide cohort study using the national health insurance claims database in Japan
Statin persistence and adherence among older initiators: A nationwide cohort study using the national health insurance claims database in Japan
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DOI：
10.1002/pds.5622
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发表时间：
2023-04-01
影响因子：
2.6
通讯作者：
Iihara，Naomi
中科院分区：
文献类型：
--
作者：
Tomida，Junko;Yoshida，Tomoji;Iihara，Naomi
PurposeThis study clarified the reality of persistence and adherence to statin in older Japanese people who initiated statin use and compared it between primary and secondary prevention coholts.MethodsThe national study using the national claims database targeted statin initiators against ≥55 years from FY2014 to FY2017 in Japan.对他汀类药物的持续性和依从性进行了总体分析，并根据基于性别、年龄分层和预防队列的亚组进行了分析。采用了按处方向个体提供他汀类药物的中位天数的允许间隙。持续率估计为Kaplan-Meier估计值。在持久性差的坚持进行了评估，并定义为<0.8天的比例covered.ResultsOf 3 675 949发起人，约80%的启动他汀类药物使用强的变种。1年时的持续率为0.61。在所有患者中，持续使用他汀类药物的依从性差为8.0%，该值随着年龄的增加而逐渐改善。一级预防队列的持续率和依从性低于二级预防队列，在二级预防队列中观察到显著的性别差异，女性的持续率和依从性较低，但在无和有高危因素的一级预防队列中几乎从未观察到，且观察到轻微差异。结论：许多他汀类药物启动者在他汀类药物启动后不久就停用了他汀类药物，但他汀类药物治疗的依从性良好。需要密切观察老年患者是否停用他汀类药物，并听取其停用原因，特别是对于一级预防中的启动者和二级预防中的女性。
PurposeThis study clarifies the reality of persistence and adherence to statins in older Japanese people who initiated statin use and compares it between primary and secondary prevention cohorts.MethodsThe nationwide study using the national claims database targeted statin initiators aged ≥55 years from FY2014 to FY2017 in Japan. Persistence and adherence to statins were analyzed overall and according to subgroups based on sex, age stratum, and prevention cohorts. Permissible gap of median days that statins were supplied per prescription to an individual was employed. Persistence rates were estimated as Kaplan–Meier estimates. Poor adherence during persistence was evaluated and defined as <0.8 of the proportion of days covered.ResultsOf 3 675 949 initiators, approximately 80% initiated statin use with strong variants. The persistence rate at 1 year was 0.61. Poor adherence to statins during persistence was 8.0% in all patients and this value gradually improved with increasing age. Persistence rate and adherence were lower for the primary prevention cohort than for the secondary prevention cohort, and a notable sex difference was observed for the secondary prevention cohort, which was lower in females but was almost never and slightly observed in the primary prevention cohorts without and with high‐risk factors, respectively.ConclusionsMany statin initiators discontinued statins shortly following statin initiation but adherence while on statin therapy was good. Attentively watching older patients not to discontinue statins and listening to their reasons for discontinuation are required, especially for initiators in primary prevention and females in secondary prevention.