July 3, 2012

Statins Discontinued Because of Side Effects;
Prescribers Often Not Consulted

Salt Lake City, UTA quarter of a century after the first statin was approved for treatment of high cholesterol, medication adherence remains a difficult issue to resolve. Some studies have suggested that as many as 78% of patients stop therapy within a year.

A recent survey involving more than 10,000 statin users, "Understanding Statin use in America and Gaps in Education," (USAGE) looked at the reasons why medication adherence is so problematic with statins. They found that side effects, such as muscle pain and weakness, was the most common reason for discontinuing the drug, cited by 62% of respondents. Cost (17%) and lack of treatment efficacy (12%) were also mentioned. More than a third (34%) stopped taking their drugs before consulting their physician.

"Heart attack and stroke are the greatest cause of death and disability in the U.S. Despite considerable research showing that statin drugs can help prevent these diseases, many Americans fail to take their statin as prescribed by their doctor," said Eliot Brinton, MD, spokesman for the National Lipid Association, who also serves as director of Atherometabolic Research at the Utah Foundation for Biomedical Research. His groups fielded the survey, sponsored by Kowa Pharmaceuticals America and Eli Lilly.

The report of the survey, published online in the Journal of Clinical Lipidology, raised some issues about lack of knowledge about hypercholesterolemia as well as inadequate patient education and counseling about drug and/or supplement interactions with therapies used to treat it.

The USAGE survey was conducted from September 21, 2011 to October 17, 2011, with an Internet-based, self-administered questionnaire developed by Kantar Health. All participants said they were over 18 years old and had a doctor's diagnosis of high cholesterol. Respondents had a mean age of 61 and were predominantly Caucasian (92%), female (61%), and middle income ($62,912/yr), and were insured (93%).

Survey authors cautioned that the group was not representative of all Americans or even statin users.

Findings included:

• While 64% of the respondents remembered their pant size from high school, only 46% knew their most recent cholesterol level;
• Three-quarters of the female survey respondents could not remember their initial LDL-C readings, and more than half could not recall their most recent LDL-C levels;
• While the average respondent reporting using three prescription and/or nonprescription products, only 38% of all respondents said they were worried about potential drug interactions.

Interestingly, 40% of respondents, who said they were concerned about potential drug interactions but who did not speak with their doctor about the issue, said they instead relied on their pharmacist to identify potential interactions. In fact, 57% believe the pharmacist is primarily responsible for alerting them to drug interaction problems.

The survey report suggested that view could be a problem since pharmacists are not always are of individual patient's "complete treatment regimen (including prescriptions, non-prescription and supplement use) since patients may get their prescriptions filled at more than one pharmacy."

The USAGE survey Web site provides downloadable tools and resources, including patient- and medical provider-directed Discussion Guides and a Medication Tracker.

U.S. Pharmacist Social Connect