Abstract
Background/Aims Statin medications are commonly prescribed to lower cholesterol and the risk for cardiovascular events. Few published studies have, however, explored factors that may contribute to primary non-adherence with statins. We aimed to determine patients’ reasons for non-adherence with newly prescribed statin medication.
Methods We identified Kaiser Permanente (KP) Southern California members aged =24 years with a new order for a statin prescription between May 10 and June 5, 2010 not redeemed within five weeks of the order date and with 12 months of continuous membership prior to the statin order. New orders were defined as the patient having no statin prescriptions in the previous 12 months. Among 1,157 eligible patients indicating English as their preferred language, we randomly selected patients and conducted 98 semi-structured telephone interviews about factors and perceptions that contribute to non-adherence.
Results At six weeks post-index prescription date, 73% of respondents (74/98) reported not filling their new statin prescription while 23% (21/98) picked it up from a non-KP pharmacy. The three most commonly cited reasons for primary non-adherence were general concerns about taking the medication (63%; 46/73), a decision to try lifestyle modifications instead of taking the medication (63%; 46/73), and fear of side effects (53%; 39/73). One-third of respondents (33%; 24/72) reported taking over-the-counter products to lower their cholesterol. The majority of respondents agreed with the importance of the medication (63%; 45/73) but worried that the prescription would cause more harm than good (62%; 46/73). Fewer respondents (22%; 16/74) were burdened by the out-of-pocket expenses for the medication.
Conclusions Although most respondents were convinced of the importance of their newly prescribed statin medication, they expressed concerns about adverse effects. In addition, respondents expressed a desire to modify their diet and exercise, and/or take non-prescription products to lower their cholesterol. These findings are consistent with other studies that have assessed patient factors related to adherence with statin therapy. These data warrant the need for interventions that address patients’ negative perceptions of statins while emphasizing the benefits of statins for reducing cardiovascular morbidity and mortality.
