The Pharmaceutical Journal
Vol 269 No 7213 p273
31 August 2002

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Heart Online (heart.bmjjournals.com)

Women more likely to adhere to statins

Women are more likely to adhere to statin treatment than men following myocardial infarction (MI), researchers in Scotland have found. Furthermore, patients who adhere well to statin therapy are less likely to suffer a further MI than those who do not.

Dr Li Wei and colleagues from the Medicines Monitoring Unit at Ninewells Hospital and Medical School, Dundee, used a database linking patients' health records to examine how frequently statins were prescribed for patients after an MI and how well patients adhered to statin treatment. The database contained hospital discharge data and information about dispensed community prescriptions.

During the study period — January 1990 until December 1995 — 5,590 patients experienced an MI but only 7.7 per cent received statin treatment following discharge from hospital. The researchers suggest that this was because at that time the evidence base for statin therapy post-MI was not strong.

The researchers found that compared with patients who did not receive statins, patients who adhered well to statin therapy (80 per cent adherence or greater) were less likely to suffer a further MI. Those who did not adhere well showed no improvement compared with those not treated with statins. "[The] highly compliant subjects had a very good outcome with an 81 per cent reduced risk of recurrent MI and 53 per cent reduced risk of all-cause death compared to subjects not prescribed statins once all other factors had been adjusted for. Subjects who had less good compliance did not have statistically significantly improved outcome," said Professor Tom Macdonald, one of the study authors.

The researchers say that women were more likely to adhere to treatment, although they were less likely to be prescribed statins than men.

Professor MacDonald told The Journal that the study demonstrated the pivotal importance of patient compliance in the real-world community setting. "Promoting good compliance with medicines is a major challenge for the delivery of effective health care interventions," he said.

The researchers also found that older patients were less likely to be prescribed statins than young patients and that, overall, patients living in more deprived areas were prescribed statins most often (Heart 2002;88:229).