Real-world adherence and effectiveness of lipid-lowering biological therapy in a Spanish cohort: an observational...

To evaluate adherence to proprotein convertase subtilisin/kexin type 9 inhibitors in patients with primary hypercholesterolemia and dyslipidemia, identify factors influencing adherence and assess its effectiveness in reducing lipid levels.

A cross-sectional observational study was conducted in a tertiary hospital. Adherence was assessed using three methods: the simplified medication adherence questionnaire, the proportion of days covered, and the visual analog scale. Demographic and clinical variables were collected, and logistic regression analysis was performed to identify factors associated with adherence. Lipid parameter changes were evaluated using Student's t-test.

A total of 102 patients were included. The mean age (SD) was 61 years (±10.7), and 65% (66) were males. The mean adherence rate was 79.5% using the simplified medication adherence questionnaire, 97% with the proportion of days covered, and 90.2% with the visual analog scale. Younger patients (<60 years) had significantly higher adherence (p = 0.025), while those living alone (p = 0.047) and those perceiving difficulty in medication administration (p = 0.044) showed lower adherence. LDL cholesterol levels decreased by 59.2% after one year of treatment. No significant differences were found between adherent and non-adherent patients regarding total cholesterol or LDL cholesterol reductions, but adherent patients showed a greater reduction in triglycerides (p = 0.0508).

Adherence and effectiveness of proprotein convertase subtilisin/kexin type 9 inhibitors in real-world settings appear promising in our cohort. However, older adults, individuals living alone, and those who perceive difficulties with medication administration showed lower adherence, suggesting that targeted strategies are needed for these groups. Interventions such as patient education, close monitoring, and regular follow-up could help further optimize adherence and clinical outcomes.