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A study of patients recommended for statin treatment found that 59.2% of those who did not receive treatment said they had never received a statin from their doctor. Black adults, women, and uninsured patients were the most likely to report never being offered statins.
"We need to focus on improving the way physicians identify patients who need to be treated with a statin and how they present information to patients to make sure no one misses it." the opportunity to improve one's heart health, "said Corey Bradley, MD. Lead author of the study and researcher at the Duke Clinical Research Institute in Durham, North Carolina.
The study included 5693 adults out of 7938 adults from the PALM (Transverse Lipid Treatment Assessment Registry) registry that were recommended for statin therapy according to the 2013 American College of Cardiology and the American Heart Association.
guideline. At registration, basic laboratory lipid panels were set up and participants responded to a digital survey.
Overall, 26.5% (n = 1511) of patients recommended for statin therapy did not receive them at this time. Of these, 59.2% (n = 894) reported never having received a statin, 30.7% (n = 464) reported stopping a statin and 10.1% (n = 153) ) received and declined an offer of statin treatment.
Bradley pointed out that some participants may not have remembered being offered a statin, so the percentage of participants never having received statin treatment offerings may have been overestimated. "However, we think that if the patient did not remember the conversation, it was probably not effective," she said.
Compared with patients who were actively receiving statin therapy, participants who reported never having received statins were more likely to be women (51.1% versus 39.4%). P <0.001), Black (20.9% vs. 12.1%) and Hispanic (14.0% vs. 10.1%, P = 0.0005).
Of the 153 participants who refused statin therapy, 36.8% said they feared side effects, 25.0% said they preferred to focus on diet or exercise and 19.4% said felt that statins were not necessary. Among the patients who discontinued statins, the most frequently cited reason for discontinuation was perceived adverse events (55.0%). Only 18.2% of those who stopped smoking felt that they no longer needed a statin.
"Although there are risks badociated with statins, the public's fear of side effects is out of all proportion to the real risks," said Ann Marie Navar, MD, Ph.D., author Principal of the study and Assistant Professor of Medicine at the Duke Clinical Research Institute. . "Misconceptions about statins are everywhere and are fed by false information on the Internet. We need better tools to fight this type of misinformation. "
Many patients who had never tried a statin or who had stopped treatment were still willing to consider statin therapy. Of those who had never been given a statin, 41.9% were "very likely" or "almost certainly" willing to take a statin and 25.8% were "possibly" willing to try the treatment. Only 16.7% said they did not want to take a statin. Of those who discontinued statin therapy, 38.4% were "very likely" or "almost certainly" willing and 21.3% were "possibly" willing to take a statin. Only 29.1% did not want to resume statin therapy and 11.2% did not know or did not respond.
The investigators discussed the implications of these findings by writing that providers should have an open conversation with patients about whether to start or retry statin therapy.
"Doctors should not hesitate to resume conversation about the beginning or retest of statin therapy in patients who might benefit but who are not currently on treatment," said Bradley.
The study entitled "Reasons statin therapy was discontinued or discontinued by patients – information from the PALM register" was published in Journal of the American Heart Association.
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