Many patients eligible for statins do not take medication and say the doctor is to blame

Many patients eligible for statin therapy who do not currently take it say they do not remember being offered one of these lipid-lowering drugs by their doctor, according to a new badysis of the drug. 39; evaluation of patients and treatment providers of lipid management (PALM) registration.

According to the researchers, the results highlight the need to improve communication between physicians and patients on diabetes treatment, even for those who do not remember receiving treatment, and even those who do not start to fear potential side effects.

"These data are reported by patients and this is certainly a limitation – the patients may not have remembered the conversation – but that means that the conversations are not effective enough at the moment," he said. Chief Corey Bradley, MD (Duke University Medical Center, Durham, North Carolina)), said TCTMD. "We need to improve our communication with people, make sure that they understand why we are talking about it and have this conversation more than once."

The new study, published on March 27, 2019, in the Journal of the American Heart Association, is an attempt to understand why eligible patients, including those at high risk for atherosclerotic cardiovascular disease (ASCVD) and those with previous ASCVD, are not receiving treatment. "It's a question that has not been asked to patients yet," she said. "We wanted to not only understand why patients do not take their statins, but also, in the future, better integrate the preferences and motivations of patients in our discussions about preventive treatment."

A quarter of eligible patients not taking a statin

The PALM registry was designed to provide a cross-sectional badessment of lipid management practices and beliefs of patients and providers on cholesterol, statin therapy and heart disease in 140 cardiology, primary care and treatment practices. endocrinology in the United States. Using the 2013 cholesterol guidelines from the American College of Cardiology and the American Heart Association, researchers identified 5,693 adults eligible for statin therapy.

Overall, 26.5% of eligible patients did not take statins. Of the 1,511 patients not taking statins, 894 said they were never offered lipid-lowering therapy, 153 declined treatment, and 464 started but discontinued statin therapy. Black adults, women and those without health insurance were the least likely to be offered statin therapy.

Among patients who have declined a statin or have stopped taking the drug, the most commonly cited reason is fear of side effects or perceived side effects. For those who refused, 25.0% said they wanted to try a diet or exercise, 19.4% did not think they needed it and 16.0% had a preference for natural remedies. Of those who stopped a statin, 55% reported experiencing adverse events, while 18.2% said they no longer needed this drug. The cost problems, the preference for natural remedies and the fact of not noticing improvement with the treatments were other reasons for stopping.

Bradley told the media that there was a lot of misinformation about the side effects of statin therapy and that this could have a serious impact on public health. For this reason, thoughtful conversations about statins with patients are essential, and physicians should encourage patients to raise concerns about treatment. Fortunately, 60% of patients who had stopped statin therapy were willing to start again. That's why, instead of treating patients who have turned down statins as a "closed door," it's an invitation to resume conversation in the future, Bradley said.