Poor Adherence with Hypolipidemic Drugs: A Lost Opportunity

Authors

  • Dr. Ross T. Tsuyuki Pharm.D., FCSHP,

    Corresponding author
    1. Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada
      Division of Cardiology, Faculty of Medicine and Dentistry, University of Alberta, 213 Heritage Medical Research Centre, Edmonton, Alberta, Canada T6G 2S2
    Search for more papers by this author
  • Dr. Tammy J. Bungard Pharm.D.

    1. Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada
    Search for more papers by this author

Division of Cardiology, Faculty of Medicine and Dentistry, University of Alberta, 213 Heritage Medical Research Centre, Edmonton, Alberta, Canada T6G 2S2

Abstract

All articles assessing adherence to hypolipidemic drugs were reviewed and categorized by patient population (clinical trial, unselected) and reported as rates of nonadherence and discontinuation. Overall, levels of discontinuation reported in clinical trials (6–31%) and lipid clinics (2–38%) are similar, with unselected populations consistently reporting higher rates (15–78%). Rates of nonadherence in clinical trials and lipid clinics also are comparable, with unselected populations having the highest rates. Across all settings, rates of discontinuation and nonadherence are consistently reported to be poorer with resins and niacin than with hydroxy-6-methylglutamate coenzyme A reductase inhibitors. Adherence to hypolipidemic agents appears to decrease in parallel with level of follow-up. Data evaluating mechanisms of poor adherence are limited. While the search for new, efficacious therapies must continue, efforts focused on improving adherence to proven therapy may have a greater overall impact on health than any single new agent.

Ancillary