Prescribing patterns, adherence and LDL ‐cholesterol response of type 2 diabetes patients initiating statin on low‐dose versus standard‐dose treatment: a descriptive study

Summary Aims The aim of this study was to describe and compare treatment modifications and discontinuation, adherence levels and response to treatment in patients with type 2 diabetes initiating on low‐dose vs. standard‐dose statin treatment. Methods A 2‐year follow‐up cohort study was performed using data from the Groningen Initiative to Analyse Type 2 Diabetes Treatment ( GIANTT ) database in patients with type 2 diabetes initiating statin treatment between January 2007 and December 2012. First, we determined whether there were differences in treatment modifications and discontinuation after statin initiation between patients starting on a low‐dose vs. standard‐dose. Second, we looked at differences in adherence and LDL ‐cholesterol response after 2 years follow‐up between these groups. Results Around 22% of patients initiated statin treatment on a dose lower than recommended. More than half of them remained on a low dose during a 2‐year follow‐up period, whereas less than 15% received a dose increase. Of the patients initiating on standard‐dose, also more than half remained on the same treatment during this period, whereas 8% received a dose decrease without subsequent increase. Over 25% of patients starting on low‐dose or standard‐dose treatment discontinued treatment, often within the first 180 days after initiation or after a first treatment change. Patients on low‐dose treatment had lower adherence levels and were less likely to have adequate LDL ‐cholesterol response compared with patients on standard‐dose after 2 years follow‐up. Conclusions Current patterns of statin treatment in patients with type 2 diabetes are suboptimal, with discontinuation, inadequate adherence levels and lack of treatment intensification seen in those who had inadequate LDL ‐cholesterol response after 2 years of follow‐up. Patients starting on low‐dose had more treatment modifications, discontinuation and adherence problems as compared with those starting on standard‐dose treatment, which calls for a closer look at the rationale of starting patients on low‐dose statin treatment.