Patient-Reported Reasons for Declining or Discontinuing Statin Therapy: Insights From the PALM Registry

Area of Science:

• Cardiology
• Preventive Medicine
• Health Services Research

Background:

• Many adults eligible for cardiovascular disease prevention via statin therapy remain untreated.
• Underutilization includes noninitiation, refusal, and discontinuation of statins.

Purpose of the Study:

• To investigate patient-reported reasons for statin underutilization.
• To identify factors associated with statin non-prescription and patient beliefs regarding statins and cardiovascular risk.

Main Methods:

• Analysis of 5693 adults recommended for statin therapy from the Patient and Provider Assessment of Lipid Management (PALM) registry.
• Patient surveys assessed statin experience, reasons for non-adherence, and beliefs about statin safety and efficacy.

Main Results:

• 26.5% of eligible adults were untreated; 59.2% were never offered a statin, 10.1% declined, and 30.7% discontinued.
• Fear of side effects was the primary reason for declining or discontinuing statins.
• Untreated patients expressed lower belief in statin safety and efficacy compared to users.

Conclusions:

• Over half of eligible but untreated patients were never offered statin therapy.
• Concerns regarding side effects are a major barrier to statin use.
• A significant proportion of patients are willing to consider or reconsider statin therapy.