March 27, 2019
Many statin-eligible patients report that they have gone untreated because they have never been offered statins, according to the results of a recent study.
Despite 2013 guidelines that broadened recommendations for statins to include over 12 million newly eligible adults, a large gap in statin use still remains, according to the authors of the study.
Using data from the Patient and Provider Assessment of Lipid Management registry, the researchers sought to investigated patient-reported reasoning for statin underutilization. Five-thousand and ninety-three adults were surveyed, of whom 1511 (26.5%) were not being treated. Of those not taking a statin, 894 (59.2%) reported that they were never offered a statin, 153 (10.1%) had declined a statin, and 464 (30.7%) had discontinued therapy.
Those most likely to have never been offered a statin were women (relative risk [RR] 1.22), black adults (RR 1.48), and those without insurance (RR 1.38). Fear of side effects and perceived side effects were the most common reasons for refusal or discontinuation of statins. Of the patients never offered a statin, 67.4% were willing to initiate, while 59.7% of those who discontinued treatment reported being willing to try again.
“Significant opportunity for improvement in statin utilization remains among adults eligible for but not on statin therapy in the United States, the authors concluded. “Perceptions about statin safety, rather than perceptions about atherosclerotic cardiovascular disease risk or statin benefit, appear to be driving statin underutilization among those who decline or discontinue therapy.”
Bradley CK, Wang TY, Li S, et al. Patient‐reported reasons for declining or discontinuing statin therapy: insights from the PALM registry [published online March 27, 2019]. JAHA.https://www.ahajournals.org/doi/full/10.1161/JAHA.118.011765.