High but not low self-reported statin adherence was confirmed by a novel method based on plasma-statin measurements in coronary outpatients. (11th May 2021)

• Record Type: Journal Article
• Authors: Kristiansen, O; Sverre, E; Peersen, K; Fagerland, MW; Gjertsen, E; Gullestad, L; Perk, J; Dammen, T; Husebye, E; Vethe, NT; Munkhaugen, J
• Is Part Of: European journal of preventive cardiology. Volume 28:Supplement 1(2021)
• Publication Date: 2021-05-11
• Subjects: Cardiovascular system -- Diseases -- Prevention -- Periodicals; Cardiac patients -- Rehabilitation -- Periodicals; 616.12
• DOI: 10.1093/eurjpc/zwab061.289
• Languages: English
• ISSNs: 2047-4873

Abstract

Abstract: Funding Acknowledgements: Type of funding sources: Public hospital(s). Main funding source(s): Helse Sør-Øst Background: To what extent self-reported adherence measures correspond with directly measured statin adherence is unknown. Purpose: To determine the relationship between, self-reported adherence measures, low density lipoprotein-cholesterol (LDL-C) and directly measured statin adherence in coronary outpatients. Methods: Patients on atorvastatin (N = 373) participated in a cross-sectional study median 16 months after a coronary event. Adherence to statins the past 7 days, general medication adherence assessed by the 8-item Morisky medication adherence scale (MMAS-8), and the Gehi adherence question was obtained by a self-report questionnaire. Atorvastatin was determined in spot blood plasma samples by a novel liquid-chromatography tandem mass-spectrometry method discriminating between adherence (0-1 doses omitted) and reduced (≥2 doses omitted) adherence. Participants were unaware of the atorvastatin analyses at study participation. Results: Mean age was 63 (SD 9) years and 19% were females. Mean atorvastatin dose was 64 (SD 21) mg. The number with reduced adherence by the different measurement methods, Cohens kappa agreement score between the self-reported and direct adherence measures, and LDL-C are shown in the Table. Statin adherence was confirmed by the direct method among 96% reporting high statin adherence the past 7 days, among 95% reporting high adherence on the MMAS-8 and among 94% reporting high adherence on the Gehi adherence question. In contrast, among patients classified with reduced statin adherence by the direct method, only 40% reported reduced statin adherence the past week, 32% reported reduced adherence with the MMAS-8 and 22% with the Gehi adherence question. Conclusions: The direct method confirmed high, but not low, self-reported statin adherence in this selected sample of coronary outpatients. In patients with elevated LDL-cholesterol, plasma-statin measurements emerges as a potential improvement for clinical statin management.