title: Statin use in American Indians and Alaska Natives with coronary artery disease.
abstract: OBJECTIVE
  The use and adherence to statin therapy in American Indians and Alaska Natives with coronary artery disease (CAD) were studied.
  
  
  METHODS
  A retrospective database analysis of the Phoenix Area of the Indian Health Service was conducted. For the cohort of patients with CAD, prescription data were obtained for all statins during calendar year 2003. Use was determined by the presence of at least one statin prescription, whereas adherence was assessed using the medication possession ratio (MPR), persistence, and median gap.
  
  
  RESULTS
  The study cohort was composed of 2095 adults (55.6% men) with at least one medical encounter for CAD during calendar year 2002. The mean +/- S.D. age of the cohort was 62.7 +/- 12.7 years. At least one prescription for any statin drug during 2003 was found for 865 (41.3%) patients. Those who received a statin were more likely to be male, be younger than 80 years, and have a greater number of medical visits. The mean MPR was 0.78 +/- 0.25, and nonadherence was found in approximately 40% of patients receiving statins. In the age category of 65-79 years, men were more adherent than women, and patients in this category were overall more adherent than younger patients.
  
  
  CONCLUSIONS
  The use of statins in a cohort of American Indians and Alaska Natives at high risk for cardiovascular events was approximately 40% with a 60% adherence rate. Age, sex, and number of medical visits were associated with statin use, and age and sex were associated with adherence.
authors.affiliation: Pfizer U.S. Pharmaceuticals, Ellicott City, MD, USA. cecooke1@hotmail.com
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Cooke
authors.forename: James L
authors.initials: JL
authors.lastname: Bresette
authors.forename: Rozina
authors.initials: R
authors.lastname: Khanna
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003327:Coronary Disease / Q000188:drug therapy*; D004363:Drug Utilization; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007198:Indians, North American; D004930:Inuit; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012189:Retrospective Studies
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors