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Published on: November 10, 2017

Lipid-Lowering Therapy Preferences in the LISTEN-LDL-US Study: A Survey of U.S. Patient Treatment Experiences and

Michael G Nanna1, Alejandro Victores2, Kyle Snyder2

  • 1Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA.

JACC. Advances
|August 19, 2026
PubMed

Insights

Patient preferences for lipid-lowering therapy (LLT) show a strong preference for oral medications over injections. Understanding these preferences, particularly for mode of administration, is key to improving treatment adherence for atherosclerotic cardiovascular disease (ASCVD).

Area of Science:

  • Cardiology
  • Pharmacology
  • Health Services Research

Background:

  • Low-density lipoprotein cholesterol (LDL-C) is a critical modifiable risk factor for atherosclerotic cardiovascular disease (ASCVD).
  • Underutilization of lipid-lowering therapy (LLT) and failure to meet LDL-C goals remain significant clinical challenges.
  • Patient-centered approaches are needed to enhance LLT adoption and adherence.

Purpose of the Study:

  • To investigate patient preferences for various attributes of lipid-lowering therapies.
  • To inform shared decision-making processes to improve LLT adherence.
  • To identify key factors influencing patient choice in LLT.

Main Methods:

  • A cross-sectional, web-based survey was administered to adults (≥40 years) with elevated LDL-C.
  • A discrete choice experiment assessed preferences for 7 LLT attributes, including efficacy and administration route.
  • Hierarchical Bayesian modeling was used to estimate preference weights and relative importance.

Main Results:

  • Mode of administration was the most significant factor influencing LLT preference.
  • Participants strongly favored once-daily oral pills over other regimens, including injections.
  • Higher perceived ASCVD risk correlated with greater emphasis on cardiovascular risk reduction over administration convenience.

Conclusions:

  • The mode of administration is a primary determinant of patient preference for LLT.
  • Integrating patient preferences into shared decision-making can enhance adherence to guideline-directed LLT.
  • Tailoring LLT based on patient preferences may improve the management of hyperlipidemia and reduce ASCVD events.
Abstract

Keywords:
ASCVD riskdiscrete choice experimenthyperlipidemialipid-lowering therapypatient preference

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