Determinants of compliance with statin therapy and low-density lipoprotein cholesterol goal attainment in a managed care population.
OBJECTIVE
To identify determinants of medication compliance and low-density lipoprotein cholesterol goal attainment.


METHODS
This retrospective analysis used claims data from a large, national, employment-based independent practice association database. Subjects were identified based on the existence of a filled prescription for statin therapy between April 1, 1999, and June 30, 2001. Subjects had to be 18 years or older, continuously enrolled in the health plan for 2 years, and new users of statin therapy.


METHODS
Multivariate logistic regression models were used to identify predictors of compliance and goal attainment in high-risk subjects.


RESULTS
As the mean copayment for statins increased, there was a decrease in the likelihood of compliance. Of the subjects with laboratory results, 50.7% attained their low-density lipoprotein cholesterol goal level established by National Cholesterol Education Program Adult Treatment Panel III guidelines. Older individuals and men were more likely to reach their low-density lipoprotein cholesterol target goal, as were individuals who were compliant with their statin therapy.


CONCLUSIONS
Compliance with statin therapy in the managed care setting remains poor. Of particular concern is the lower level of compliance among women and younger high-risk patients, along with patients who have fewer outpatient visits associated with hyperlipidemia and lower incidences of cholesterol testing.
Schultz
Jennifer S
JS
Department of Economics, University of Minnesota, 165 SBE, 412 Library Drive, Duluth, MN 55812, USA. jschultz@d.umn.edu
O'Donnell
John C
JC
McDonough
Ken L
KL
Sasane
Rahul
R
Meyer
Jay
J
D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D008078:Cholesterol, LDL / Q000097:blood*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D008329:Managed Care Programs / Q000458:organization & administration*; D008875:Middle Aged; D010349:Patient Compliance; D012189:Retrospective Studies
D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors