Patients' perspectives on statin therapy for treatment of hypercholesterolaemia: a qualitative study.
BACKGROUND
Health Care Practitioners' attempts to implement secondary prevention targets for coronary heart disease (CHD) may be restricted by low rates of persistence with statin therapy. There is a need to understand why some patients, despite having established CHD and elevated cholesterol, do not comply with their prescribed statin regimen.


OBJECTIVE
To explore patients' perspectives on compliance with statin therapy.


METHODS
Primary care, West of Scotland.


METHODS
The research approach was qualitative. Thirty-three patients prescribed statin therapy and identified as having different patterns of compliance (poor moderate and good) were interviewed. The in-depth interviews were conducted on a one to one basis. Patients prescribed statin therapy for less than three months were excluded. Data were analysed thematically with the assistance of QSR Nudist.


RESULTS
From analysis of the narrative data, two broad categories, i.e. 'Patient-health care provider communication' and 'Health beliefs' were identified. These categories encompassed six main themes: 'Initiation of therapy'; 'Subsequent feedback'; 'Sources of misconceptions'; 'Unconditional acceptance'; 'Conditional acceptance'; 'Deferment and Rejection'. Acceptance of and compliance with statin therapy appeared to be associated with the provision, interpretation and feedback of information during patient-practitioner consultations, and patients' beliefs about personal health status, cholesterol, and recommended cholesterol-lowering strategies.


CONCLUSIONS
Patients' beliefs and understanding about cholesterol, and the role of cholesterol modifying strategies should be determined prior to the initiation of therapy and at appropriate intervals thereafter.
Tolmie
Elizabeth P
EP
Nursing and Midwifery School, University of Glasgow, 59 Oakfield Avenue, G12 8SW, Glasgow, Scotland, UK. e.p.tolmie@clinmed.gla.ac.uk
Lindsay
Grace M
GM
Kerr
Susan M
SM
Brown
Malcom R
MR
Ford
Ian
I
Gaw
Allan
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D030141:Feedback, Psychological; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010353:Patient Education as Topic / Q000592:standards; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000592:standards; D036301:Qualitative Research; D012606:Scotland; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors