Improving patient adherence to statin therapy would help save more lives than ‘merely’ dishing them out to more people, according to fresh research published in the Journal of Epidemiology and Community Health.
Researchers carried out a review of publications on adherence to statin therapy in clinical trials and normal practice alongside a simulation of the expected benefits of strategies to increase the number of statins prescribed, and found that a strategy concentrating on improving treatment adherence in those patients already taking the cholesterol lowerers would prevent more deaths than increasing the number of people eligible for treatment.
National Health Service cost watchdog the National Institute for Health and Clinical Excellence currently recommends that doctors prescribe statins to anyone with a 20% or greater chance of having a heart attack or stroke in the next decade. But evidence suggests that only around half of those given statins as a preventative measure are still taking them five years later.
Calls are growing to extend the target population for statin therapy in the UK based on evidence showing that, if adhered to properly, the drugs can cut the risk of death by 45% in those with no indication of cardiac illness as well as those at risk from heart disease.
However, the researchers point that that achieving a 50% improvement in current rates of treatment adherence in higher risk patients would actually prevent twice as many deaths from cardiovascular disease than ‘merely’ dishing them out to more people, and suggest that this would also likely be a much more cost-effective strategy too.
Consequently, they stress that more work is needed in order to determine the best ways to help patients stick to therapy, and point out that, while measures such as telephone reminders and better patient information may, as suggested by various Cochrane reviews, may improve treatment adherence in the short term, their long-term effectiveness is unknown.
