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

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.