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Factors associated with low compliance with lipid-lowering drugs in hyperlipidemic patients


Eric Bruckert MD Professor of Endocrinology, Service d’Endocrinologie-Métabolisme, Hôpital Pitié Salpétrière, 83 boulevard de l’Hôpital, 75013 Paris, France. Tel.: +33 1 42 17 78 68; fax: +33 1 42 17 78 65; e-mail:


Background: Treatment with lipid-lowering drugs decreases the risk of having a cardiovascular event by 30% according to several large intervention trials. However, both in these trials and in clinical practice the rate of discontinuation of medical treatment and the frequency of low compliance are high.

Objective: The purpose of the study was to determine factors associated with poor compliance.

Methods: We studied 193 hyperlipidemic subjects who had been referred to an out-patient clinic and who were treated with at least one antihyperlipidemic drug. The patients were asked to fill in a questionnaire which explored various factors that could possibly affect compliance. Compliance was evaluated by the percentage of pills missed during the previous month according to patient interview.

Results: Younger subjects and smokers were less compliant. Perception of frequent side-effects to the current antihyperlipidemic treatment and high number of medications were inversely correlated with compliance (P=0·0237 and P=0·0311, respectively). Frequent breaking of appointments with a physician were inversely correlated with compliance (P=0·026). The patient’s perception of the time that the physician spent to explain and to discuss the different aspects of cholesterol and cardiovascular disease (CVD) was correlated with a higher compliance (P=0·0125). Patients’ perception of the efficacy of antihyperlipidemic therapy to prevent a CVD event in the future was also strongly associated with adherence to treatment (P < 0·001).

Conclusions: Many factors affect compliance with antihyperlipidemic drug therapy. Good doctor–patient relationship, conviction of the efficacy of treatment and increased age are associated with compliance. Perceived high frequency of side-effects and prescription of numerous drugs negatively affect compliance.