- Title
- Higher long-term adherence to statins in rural patients at high atherosclerotic risk
- Creator
- Peverelle, Matthew; Baradi, Arul; Paleri, Sarang; Lee, Yun; Sultani, Rohullah; Toukhsati, Samia; Hare, David; Janus, Edward; Wilson, Andrew
- Date
- 2019
- Type
- Text; Journal article
- Identifier
- http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/167961
- Identifier
- vital:13796
- Identifier
-
https://doi.org/10.1016/j.jacl.2018.11.004
- Identifier
- ISBN:1933-2874
- Abstract
- Background: Rural patients with atherosclerotic cardiovascular disease (ASCVD) experience greater cardiovascular morbidity and mortality than their urban counterparts. Statin therapy is a key component of ASCVD treatment. The extent to which there may be regional differences in long-term adherence to statins is unknown. Objective: To assess long-term rates of adherence to statins in a high-risk ASCVD cohort, and whether regional differences exist between rural and urban patients. Methods: Follow-up was conducted in patients who underwent coronary angiography at a single tertiary center between 2009 and 2013. Adherence was defined as consumption of prescribed statin ≥6 days per week. Patients were divided into remoteness areas (RAs), classified as RA1 (major city), RA2 (inner regional), and RA3 (outer regional) based on the Australian Standard Geographical Classification. Results: Five hundred twenty-five patients (69% male, mean age 64 ± 11 years) were followed-up after a median of 5.3 years. Baseline characteristics were similar between RAs. Overall adherence was 83%; however, rural patients were significantly more adherent to their statin therapy (80% in RA1, 83% in RA2, and 93% in RA3, P =.04). Living in RA3 independently predicted greater statin adherence than living in RA1 (odds ratio: 2.75, 95% CI: 1.1–7.8, P =.03). All-cause mortality was significantly higher in RA3 than other regional areas (6% RA1, 12% RA2, and 18% RA3, P =.01). Conclusions: Despite higher all-cause mortality, rural patients with ASCVD demonstrate significantly greater long-term adherence to statins than urban patients. Other factors, such as reduced access to health care and delayed diagnosis may explain the gap in outcomes between rural and urban patients.
- Publisher
- Elsevier Ltd
- Relation
- Journal of Clinical Lipidology Vol. 13, no. 1 (2019), p. 163-169
- Rights
- Copyright © 2018 National Lipid Association
- Rights
- This metadata is freely available under a CCO license
- Subject
- 1101 Medical Biochemistry and Metabolomics; 1102 Cardiorespiratory Medicine and Haematology; Atherosclerotic cardiovascular disease; Coronary artery disease; Hydroxymethylglutaryl-CoA reductase inhibitors; Medication adherence; Patient compliance
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