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Patients with MI often nonadherent to high-intensity statin regimen
Interventions may be necessary to increase high-intensity statin adherence for patients after MI hospitalization, researchers wrote in JAMA Cardiology.
“Most Medicare beneficiaries who filled a high-intensity statin prescription following an MI hospitalization did not continue taking this medication with high adherence for 2 years after discharge,” Lisandro D. Colantonio, MD, MSc, from the department of epidemiology at the University of Alabama at Birmingham, and colleagues wrote. “Several patient and health resource use characteristics were associated with continuing high-intensity statins with high adherence. These factors could inform interventions to reduce residual [CV] risk after MI.”
To estimate the number of patients filling high-intensity statin prescriptions after MI who continue to adhere to their medication, researchers conducted a retrospective cohort study following 57,898 Medicare beneficiaries after MI hospitalization.
The study included patients aged 66 years or older who had been hospitalized for MI between 2007 and 2012 and had a high-intensity statin prescription filled within 30 days of hospital discharge.
Patterns of statin use were analyzed at 6 months, 1 year, 18 months and 2 years.
Researchers found that:
At 6 months, 58.9% of beneficiaries aged 66 to 75 years were taking high-intensity statins with high adherence; at 2 years, that number declined to 41.6% of beneficiaries.
At 6 months, 8.7% of beneficiaries aged 66 to 75 years down-titrated; at 2 years, 13.4% had done so.
Low adherence was observed in 17.3% of beneficiaries aged 66 to 75 years at 6 months and 19.1% at 2 years, whereas 12.4% discontinued statin use at 6 months and 18.8% did so by 2 years.
There was an increase in the proportion of high-intensity statin adherence between 2007 and 2012.
Black patients, Hispanic patients and those new to high-intensity statin use were not as likely to have a high adherence to prescribed high-intensity statin compared with other populations.
Patients who had dual Medicare/Medicaid coverage, a higher rate of cardiologist visits after discharge and participated in cardiac rehabilitation had a higher rate of adherence compared with other populations.
Results among beneficiaries older than 75 years were similar to those aged 66 to 75 years.
“Results from this study indicate that many patients who fill a high-intensity statin following MI hospitalization do not continue taking this medication with high adherence during the 2 years postdischarge,” the researchers wrote. “Lower medication costs, cardiologist visits and cardiac rehabilitation may contribute to improving high-intensity statin use and adherence after [MI].” – by Dave Quaile
Disclosure: Colantonio reports no relevant financial disclosures. Please see the full study for a list of the other researchers’ relevant financial disclosures.