RESEARCH ARTICLE


Initiation and Persistence to Statin Treatment in Patients with Diabetes Receiving Glucose-Lowering Medications 1997- 2006



H. Dominguez1, *, T. K. Schramm2, M. L. Norgaard1, S.Z. Abildstrøm3, 4, L. Kober2, C. Jørgensen1, T.J. Guterbaum1, H.E. Poulsen5, 6, 7, C. Torp-Pedersen1, 7, G. H. Gislason1
1 Cardiology dpt. and Lab. P, Research Unit, Gentofte Hospital, Copenhaguen University, Hellerup, Denmark
2 Department of Cardiology, Rigshospitalet. Copenhagen University, Denmark
3 Cardiovascular Research Unit, Department of Internal Medicine, Copenhagen University Hospital Glostrup, Glostrup, Denmark
4 National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
5 Laboratory of Clinical Pharmacology Q7642, Rigshospitalet, Copenhagen, Denmark
6 Department of Clinical Pharmacology, Bispebjerg Hospital, Copenhagen, Denmark
7 Faculty of Health Sciences, University of Copenhagen, Denmark


© Dominguez et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Cardiology department and Lab. P - Research Unit - Internal Post 163, Gentofte Hospital, Copenhaguen University, DK-2900 Hellerup, Denmark; Tel: +45 22 98 93 43; E-mail: hd@heart.dk


Abstract

Aims:

Since 2001 guidelines recommend statin treatment in most patients with diabetes. We investigated secular changes in initiation and persistence to statin treatment during a 10-year period in a nationwide cohort of patients initiating glucose-lowering medication (GLM).

Methods:

All Danish citizens 30 years and older who claimed prescriptions of GLM between 1997 and 2006 were identified from nationwide registers of drug dispensing from pharmacies and hospitalizations, and followed until 2006. Statin treatment was registered if a prescription was claimed during the period. By logistic regression we analyzed factors related to initiation and persistence to statin treatment.

Results:

In total 128,106 patients were included. In 1997 only 7% of the patients receiving GLM claimed statins within the first year after GLM initiation. Despite increasing statin prescriptions the following years, only 62% were using statins at the end of follow up. The chance of ever receiving statins was lowest if not initiated within 180-days following the first purchase of GLM (OR 0.75, 95% CI 0.74-0.76). A previous myocardial infarction was associated with increased statin treatment (OR 4.51; 95% CI 4.31 - 4.71), while low income was associated with lower use of statins (OR 0.68; 95%CI 0.66-0.72). Between 75-85 % of the patients who initiated statins treatment were persistent to treatment by 2007.

Conclusions:

In spite of increasing use of statins in diabetes patients over time, many patients remain untreated. Early initiation of statin treatment in diabetic patients and focus on patients with low socioeconomic status is needed to give long-term benefits.

Keywords: Diabetes, Statins, compliance, epidemiology, lipids..