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Cardiovascular risk estimation and statin adherence: a historical cohort study protocol.

Samuel Finnikin1, Brian Willis2, Rani Khatib3,4

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Low adherence to statins for cardiovascular disease (CVD) prevention is a concern. This study examines if shared decision-making (SDM), indicated by CVD risk scores, improves statin adherence and patient outcomes.

Keywords:
general practitionershydroxymethylglutaryl-CoA reductase inhibitorsmedication adherenceprimary healthcareshared decision making

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Area of Science:

  • Cardiovascular disease primary prevention
  • Pharmacological interventions
  • Health services research

Background:

  • Statin adherence for primary cardiovascular disease (CVD) prevention is suboptimal.
  • The initiation consultation and clinician factors influence patient adherence.
  • Cardiovascular disease risk estimation is crucial for shared decision-making (SDM) in statin therapy.

Purpose of the Study:

  • To determine if shared decision-making (SDM), proxied by cardiovascular disease (CVD) risk score recording, is associated with statin adherence.
  • To investigate the relationship between SDM and subsequent CVD outcomes.

Main Methods:

  • Retrospective cohort study utilizing English primary care records.
  • Inclusion of statin-naïve patients aged 40-84 years initiated on statins for primary prevention (2017-2020).
  • Analysis of statin adherence, persistence, CVD outcomes, and mortality, correlating with the presence or absence of a pre-initiation CVD risk score.

Main Results:

  • A recorded CVD risk score at statin initiation may serve as a proxy for shared decision-making (SDM).
  • The study will quantify the association between recorded CVD risk scores and subsequent statin adherence and persistence.
  • Secondary analysis will explore the link between recorded CVD risk scores and subsequent CVD events and mortality.

Conclusions:

  • This research utilizes CVD risk score recording as a proxy for SDM to explore its impact on medication adherence.
  • Findings will elucidate the connection between the quality of the initiation consultation and patient adherence and persistence with statin treatment.
  • Understanding this relationship can inform strategies to improve adherence in primary CVD prevention.