Why patients don't take statins as prescribed

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According to new research published in the Journal of the American Heart Association, many patients who could benefit from statins do not take them. 

Statins lower the amount of LDL and have been proven to lower the risk of heart attack and stroke. The American Heart Association/American College of Cardiology recommend the use of an atherosclerotic and cardiovascular disease risk calculator to assess a patient's 10-year risk for heart disease and to create a personalised plan based on the score. However, even with clear evidence of the benefits of statins, adherence to the guidelines and/or prescription is quite low. Despite national guidelines which clearly indicate that statins can lower the risk of heart attack and stroke, many eligible patients are still not taking them. 

For the purpose of this analysis, the researchers surveyed 5693 adults who participated in a registry at a cardiology, primary care or endocrinology practice. The survey findings showed that of the 26.5% patients who were not taking statins, 59.2% had never been offered the drugs. Among the patients who were not offered a statin, 22% were females, 48% were black, and 38% were without insurance. The survey findings also showed that patients in cardiology practices were more likely to be offered a statin compared to patients who were in primary care. 

Approximately 10.1% of the patients who were offered a statin declined it while 30.7% discontinued it because of a fear of side effects. Non-users of statin were more likely to believe that statins are safe compared to statin-users. 59.7% of the patients who discontinued the statin stated that they would consider retrying it. 

Dr. Ann Marie Navar, Assistant Professor of Medicine at the Duke Clinical Research Institute and senior author of the study explained that misconceptions about statins are being fuelled by false information on the Internet. There is a need to combat this type of misinformation so that the public fear of side effects is decreased.  

Overall, the study findings suggest that lack of proper statin use among eligible patients is due to two main reasons:
  • Eligible patients are never offered the drugs, and there is no physician guidance in this regard;
  • Eligible patients are stopping or refusing to take the drugs because of a fear of side effects. 

“We need to focus our efforts on improving how doctors identify patients who need to be on a statin, and how they present information to patients to ensure that no one is missing the opportunity to improve their heart health,” said Corey Bradley, MD, lead author of the study and a researcher at the Duke Clinical Research Institute in Durham, North Carolina. “Physicians should not hesitate to re-approach the conversation about starting or re-trying statin therapy in patients who could benefit but are currently not on the therapy.

Image Credit: iStock

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Bradley CK et al. (2019) Patient‐Reported Reasons for Declining or Discontinuing Statin Therapy: Insights From the PALM Registry. Journal of the American Heart Association. doi.org/10.1161/JAHA.118.011765

Published on : Thu, 4 Apr 2019

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heart attack, statins, prescription adherence, stroke According to new research published in the Journal of the American Heart Association, many patients who could benefit from statins do not take them.

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