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Factors Affecting Adherence to Statins in Hypercholesterolemic Kuwaiti Patients: A Cross-Sectional Study
Meisa Al-Foraih1, Shawn Somerset
1Public Authority for Applied Education and Training, Safat, Kuwait.
Insights
Kuwaiti hypercholesterolemic patients show low statin adherence, particularly younger individuals. Poor adherence is linked to higher coronary heart disease risk factors like elevated cholesterol.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Hypercholesterolemia is a significant risk factor for coronary heart disease (CHD).
- Statin therapy is crucial for managing hypercholesterolemia and reducing CHD risk.
- Understanding adherence patterns is vital for effective cardiovascular disease prevention strategies.
Purpose of the Study:
- To assess statin adherence rates among hypercholesterolemic patients in Kuwait.
- To identify demographic and clinical factors associated with poor statin adherence.
- To investigate the relationship between statin adherence and coronary heart disease (CHD) risk profile.
Main Methods:
- A cross-sectional study involving 200 hypercholesterolemic patients aged 30-69 years.
- Statin adherence was measured using the Morisky Medication Adherence Scale.
- Data on demographics, medical history, and risk factors were collected via interviews and laboratory tests.
Main Results:
- A high prevalence of low statin adherence (58.5%) was observed; no patients achieved high adherence.
- Younger patients (30-50 years) and those without diabetes exhibited lower adherence.
- Low statin adherence correlated with increased plasma cholesterol and low-density lipoprotein levels.
Conclusions:
- Low statin adherence is prevalent in Kuwaiti hypercholesterolemic patients, especially younger individuals.
- Factors such as age and diabetes status influence adherence.
- Reduced statin adherence is associated with an unfavorable coronary heart disease risk profile.
Objective:
This study examined statin adherence amongst Kuwaiti hypercholesterolemic patients in order to identify factors associated with poor adherence and to determine whether or not an association exists between statin adherence and the risk profile of coronary heart disease (CHD).
Subjects And Methods:
Two hundred hypercholesterolemic patients (30-69 years of age) were recruited from Kuwaiti primary healthcare clinics and interviewed about demographic characteristics, pre-existing self-reported medical conditions and prescribed medications. The Morisky Medication Adherence Scale was used to assess statin adherence (a self-reported, medication-adherence questionnaire divided into 3 levels, with a score of 8 denoting high adherence, 6 to <8 denoting medium adherence and <6 denoting low adherence). Data regarding anthropometric, psychological and serum risk factors were collected using 2 additional questionnaires, laboratory tests and bioelectrical impedance scales. Binary logistic regression was used to determine predictors of adherence and general linear modelling was used to test relationships between continuous outcomes and statin adherence.
Results:
Of the 200 participants, 117 (58.5%) reported low adherence, 83 (41.5%) reported medium adherence and no patients (0%) scored high adherence. Younger patients (aged 30-50 years) had lower adherence than older patients (>50 years) [odds ratio (OR) 1.05; 95% confidence interval (CI) 1.01-1.09] for every extra year; p < 0.01). Those without diabetes, i.e. 113 (56.5%), were less likely to report medium adherence than those with diabetes (OR 0.42; 95% CI 0.23-0.75; p < 0.01). Low statin adherence was associated with higher levels of plasma cholesterol (p < 0.001) and low-density lipoprotein (p < 0.01).
Conclusion:
In this study, there was a high prevalence of low statin adherence, especially among younger patients with fewer concomitant diseases. The results indicated an inverse relationship between statin adherence and CHD risk profile.
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