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Factors Affecting Adherence to Lipid-lowering Drugs: A Scoping Review
Abdul Hadi Said1, Ikhlas Solehah Abd Rahim1, Nur Najihah Binti Mohamad Zaini1
1Department of Family Medicine, Kulliyyah of Medicine, International Islamic University Malaysia, Selangor, Malaysia.
Insights
Patient adherence to lipid-lowering drugs is influenced by patient, medication, and healthcare factors. Improving adherence requires patient education, medication adjustments, and enhanced healthcare provider consultations.
Area of Science:
- Pharmacology
- Public Health
- Cardiology
Background:
- Dyslipidemia is a significant risk factor for cardiovascular disease.
- Poor adherence to long-term therapy affects approximately 50% of patients with chronic illnesses in developed countries.
- Understanding factors influencing adherence to lipid-lowering drugs (LLDs) is crucial for cardiovascular disease management.
Purpose of the Study:
- To systematically review and identify factors affecting patient adherence to lipid-lowering drugs (LLDs).
Main Methods:
- A systematic review was conducted, selecting articles published between January 2010 and September 2020.
- Literature search retrieved 221 reviews, with 23 selected based on inclusion/exclusion criteria.
- Factors influencing adherence were categorized into patient-related, medication-related, and healthcare worker-related.
Main Results:
- Patient-related factors include demographics, comorbidities, socioeconomic status, and health beliefs.
- Medication-related factors encompass polypharmacy, side effects, drug type, and dosing.
- Healthcare worker-related factors involve counseling, medication optimization, provider type, and hospital location.
Conclusions:
- Improving adherence necessitates patient education on dyslipidemia and LLDs, optimizing medication regimens (dosing, timing, type), and effective healthcare provider consultations.
- Further research on adherence to LLDs is needed in Malaysia due to limited existing studies.
Objectives:
Dyslipidemia is an important risk factor for cardiovascular disease. In developed countries, only 50% of patients with chronic illness adhere to their long-term therapy. This article aimed to review the factors affecting adherence to lipid-lowering drugs (LLDs).
Methods:
The searched articles were selected based on the available keywords in the title and abstract with the publication restricted between January 2010 and September 2020. Articles generated from the databases must fulfill both inclusion and exclusion criteria in the present systematic review. Our initial search retrieved 221 literature reviews. After excluding articles with irrelevant topics, a total of 23 articles were chosen for this current review.
Results:
The factors were classified based on three main factors: patient-related, medication-related, and healthcare workers-related factors. For patient-related factors, gender, age, number of family members, education level, post-hospitalization, comorbidities and cardiovascular disease risk, follow-up status, occupation, socio-economy, insurance, perception, ethnicity, and health plan were among the factors affecting adherence to LLDs. As for medication-related factors, timing, polypharmacy, duration of treatment, generic medication, intensity of medication, side effects, initiating dose, packaging, drug dosing, and type of drugs were revealed as contributing factors. In the light of healthcare workers, related factors shown were counseling, medication optimization, type of provider, and location of the hospital.
Conclusions:
Recommendations to improve adherence include educating patients on the disease itself and the importance of the treatment, modification of the dosing, timing and type of LLDs, and effective consultations by healthcare workers. Further studies need to be done in Malaysia as there is inadequate research on this topic.
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