Multivariate analysis of factors associated with persistent colesevelam treatment among patients with
Robert J Romanelli1, Angela Leahy, Trevor Jukes
1Sutter Health, San Francisco, CA, USA.
Insights
Persistent colesevelam treatment is crucial for managing hypercholesterolemia. Factors like female sex, baseline LDL-C at goal, and ezetimibe use influence treatment persistence in real-world practice.
Area of Science:
- Cardiology
- Pharmacology
- Real-world evidence
Background:
- Persistent lipid-lowering therapy is vital for optimal cardiovascular outcomes.
- Real-world data on colesevelam persistence and influencing factors are limited.
Purpose of the Study:
- To investigate patient demographics and characteristics associated with persistent colesevelam treatment in clinical practice.
- To identify factors impacting long-term adherence to colesevelam therapy.
Main Methods:
- Retrospective cohort study of adult hypercholesterolemia patients initiating colesevelam (2004-2011).
- Defined persistence as no >30-day gap in medication orders over 12 months.
- Used multivariate logistic regression to analyze factors associated with persistence.
Main Results:
- 49% of patients demonstrated persistent colesevelam treatment for ≥12 months.
- Female sex was linked to lower persistence odds (OR=0.69).
- Achieving baseline LDL-C goals and concurrent ezetimibe use increased persistence odds (OR=1.39 and OR=1.64, respectively).
Conclusions:
- Identified key demographic and clinical factors influencing colesevelam treatment persistence.
- Findings can inform strategies to enhance adherence and improve patient outcomes.
- Real-world insights into colesevelam use are crucial for optimizing lipid management.
Background:
Persistent treatment with lipid-lowering therapies is important for achieving optimal clinical outcomes. To date, no study has evaluated the real-world use of colesevelam and the factors associated with persistent colesevelam treatment.
Objective:
The primary objective of this study was to examine patient demographic and characteristics associated with persistent colesevelam treatment in real-world clinical practice.
Methods:
In this retrospective cohort study, adult patients with hypercholesterolemia, an initial order for colesevelam between January 2004 and December 2011, a low-density lipoprotein cholesterol (LDL-C) value ≤ 3 months from the initial order date (baseline), and ≥ 12 months of follow-up were identified through electronic health records. Persistent treatment was defined as no medication order gap >30 days during a 12-month period. Multivariate logistic regression was performed to assess factors associated with persistent treatment. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. A P value <.05 was considered statistically significant.
Results:
A total of 971 patients met eligibility criteria. Forty-nine percent of patients had ≥ 12 months of persistent treatment. Multivariate analysis showed that female sex (OR = 0.69; 95% CI = 0.53, 0.90; P = .004) was associated with lesser odds of persistence, whereas baseline LDL-C at goal (1.39; 1.06, 1.82; P = .015) and concomitant use of the intestinal cholesterol absorption inhibitor ezetimibe (1.64; 1.18, 2.28; P = .003) were associated with greater odds of persistence.
Conclusions:
This study identified several patient demographic and characteristics associated with persistent colesevelam treatment that may help develop strategies to improve treatment persistence and optimize clinical outcomes.
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