Open AccessLipid‐lowering treatment patterns in patients with new cardiovascular events – estimates from population‐based register data in Sweden
Author(s) -
Hallberg S.,
Banefelt J.,
Fox K. M.,
Mesterton J.,
Johansson G.,
Levin L.Å.,
Sobocki P.,
Gandra S. R.
Publication year - 2016
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.12769
Subject(s) - medicine , population , medical prescription , retrospective cohort study , cohort , medical record , cohort study , pediatrics , environmental health , pharmacology
Summary Objectives The aim of this study was to assess treatment patterns of lipid‐lowering therapy ( LLT ) in patients with hyperlipidaemia or prior cardiovascular ( CV ) events who experience new CV events. Methods A retrospective population‐based cohort study was conducted using Swedish medical records and registers. Patients were included in the study based on a prescription of LLT or CV event history and followed up for up to 7 years for identification of new CV events and assessment of LLT treatment patterns. Patients were stratified into three cohorts based on CV risk level. All outcomes were assessed during the year following index (the date of first new CV event). Adherence was defined as medication possession ratio ( MPR ) > 0.80. Persistence was defined as no gaps > 60 days in supply of drug used at index. Results Of patients with major cardiovascular disease ( CVD ) history ( n = 6881), 49% were not on LLT at index. Corresponding data for CV risk equivalent and low/unknown CV risk patients were 37% ( n = 3226) and 38% ( n = 2497) respectively. MPR for patients on LLT at index was similar across cohorts (0.74–0.75). The proportions of adherent (60–63%) and persistent patients (56–57%) were also similar across cohorts. Dose escalation from dose at index was seen within all cohorts and 2–3% of patients switched to a different LLT after index while 5–6% of patients augmented treatment by adding another LLT . Conclusions Almost 50% of patients with major CVD history were not on any LLT , indicating a potential therapeutic gap. Medication adherence and persistence among patients on LLT were suboptimal.