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Cardiovascular Risk Estimation and Statin Adherence: A Historical Cohort Study
Samuel Finnikin1, Brian Willis1, Tim Evans2
1Department of Applied Health Sciences College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
Summary
Utilizing cardiovascular disease (CVD) risk scores during statin initiation improves patient adherence and persistence with medication. This practice is linked to significant reductions in CVD and all-cause mortality, highlighting the importance of shared decision-making.
Area of Science:
- Cardiology
- Public Health
- Health Services Research
Background:
- Statin adherence for cardiovascular disease (CVD) primary prevention is suboptimal.
- Shared decision-making (SDM) may enhance statin adherence.
- CVD risk estimation is crucial for SDM in statin initiation.
Purpose of the Study:
- To investigate the association between CVD risk score presence at statin initiation and subsequent statin adherence and persistence.
- To explore the relationship between CVD risk scoring and CVD outcomes and mortality.
Main Methods:
- A cohort of 255,730 statin-naïve patients aged 40-84 initiating statins for primary prevention (2017-2020) was analyzed.
- Patients were categorized by the presence or absence of a CVD risk score at initiation.
- Multivariable modeling assessed associations with adherence, persistence, CVD outcomes, and death.
Main Results:
- The presence of a CVD risk score was observed in 67.7% of patients.
- CVD risk scoring was associated with a 7% increase in statin adherence and an 8% reduction in discontinuations.
- A 15% reduction in CVD and all-cause mortality was observed in patients with a CVD risk score.
Conclusions:
- CVD risk scoring at statin initiation is linked to improved adherence and persistence, suggesting enhanced SDM quality.
- CVD risk scoring demonstrated a significant reduction in CVD and mortality, exceeding that explained by adherence alone.
- Integrating CVD risk scores and SDM into statin initiation consultations may improve patient outcomes.
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