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07 Dec 2018
Less focus must be given on pretreatment blood pressure (BP) levels, which rarely predict future untreated BP levels or rule out capacity to benefit from BP lowering in high cardiovascular risk patients, according to recent study. Focus must be directed instead on prompt, empirical treatment to maintain lower BP for individuals with high BP or high risk.

Tailored strategies to overcome statin non-adherence

30 Nov 2018
Poor adherence to statin therapy is leaving many patients with dyslipidaemia at high risk of potentially life-threatening cardiovascular events. Statins are the current standard of care for reducing the risk of cardiovascular disease in these patients and for improving life expectancy, with possible economic benefits for healthcare systems too. However, many patients with dyslipidaemia are not achieving or maintaining treatment targets because they fail to stick to their prescribed statin therapy. An article co-authored by lipidologist Peter Lansberg, and published in Vascular Health and Risk Management, considers this issue and reviews approaches to overcome non-adherence.

A number of complex factors related to the patient, their physician and the healthcare system contribute to this problem, which is magnified by unqualified reports in traditional and social media questioning the use of statins for managing dyslipidaemia. Therefore, a multifaceted yet integrated and patient-focused approach is needed to improve adherence to prescribed therapy and optimize outcomes.

Paving the way for adherence

The physician–patient relationship is the foundation of good clinical practice, and establishing a trusting relationship is the starting point for improving statin adherence. Although it takes a lot of effort and time, engaging with patients and really gauging their understanding and beliefs about the condition and its treatment allows for a shared approach to managing risk and preventing illness.

A variety of patient education materials are now available to the clinician. These include discussion aids, videos, mobile applications and online resources. Such tools can be valuable for dispelling misconceptions and strengthening patients’ understanding of their condition, while also underscoring the importance of statin therapy. Patient counselling, medication reminders and information from digital systems have also been found to be successful strategies for boosting statin adherence. With the resulting improved adherence to statin therapy, patients are more likely to reach cholesterol targets.

"Patient counselling, medication reminders and information from digital systems have also been found to be successful strategies for boosting statin adherence."

Maintaining contact

Regular counselling by phone or other communication approaches (text messages or mail) can help support and reinforce patients’ strategies for improving statin adherence, leading to better health outcomes and improved survival.

Addressing pill burden

While pill boxes alone may not improve statin adherence, pharmacists can help increase adherence by 30% through counselling patients and offering weekly dose-dispensing packs. Fixed-dose combination of therapies reduce pill burden and are another tactic to promote adherence.

Digital technologies

Technology advancements have armed clinicians with digital tools to support their own decision-making informed by evidence-based treatment guidelines. Technology also helps clinicians continually engage patients through readily-accessible educational materials, automated reminders to refill medication and prompts regarding taking medication.

Summary

The paper observes that medication adherence is a must for achieving long-term benefits from statin therapy.Numerous tools are now available to help overcome many barriers to treatment adherence by supporting patients to realize the value of statin therapy.

HK-PFR-626-1 Figure

Reference: Lansberg P, et al. Vasc Health Risk Manag 2018;14:91–102.
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Most Read Articles
07 Dec 2018
Less focus must be given on pretreatment blood pressure (BP) levels, which rarely predict future untreated BP levels or rule out capacity to benefit from BP lowering in high cardiovascular risk patients, according to recent study. Focus must be directed instead on prompt, empirical treatment to maintain lower BP for individuals with high BP or high risk.