title: Primary nonadherence to statin therapy: patients' perceptions.
abstract: OBJECTIVE
  To identify self-reported reasons for not filling a new prescription for statin therapy.
  
  
  METHODS
  A cross-sectional telephone survey.
  
  
  METHODS
  Potential participants were identified from a randomized, controlled trial among Kaiser Permanente Southern California (KPSC) members aged >24 years with no record of redeeming a new statin medication, defined as primary nonadherence. Among 1158 eligible patients, 98 were randomly selected and participated in a semi-structured telephone interview that included questions on whether the respondent redeemed their statin prescription, why the patient may have chosen not to use a KPSC pharmacy, reasons for not filling the prescription, use of non-prescription products for elevated cholesterol levels, and questions to assess health literacy.
  
  
  RESULTS
  At 12 weeks post-index prescription date, 75% of 98 respondents reported not filling their new statin prescription, 20% reported picking it up from a non-KPSC pharmacy, 4% had already picked up the prescription at a KPSC pharmacy, and 1% did not know if it had been filled. The 3 most commonly cited reasons for primary nonadherence were general concerns about taking the medication (63%), a decision to try lifestyle modifications (63%), and fear of side effects (53%). A substantial proportion (33%) of respondents reported inadequate health literacy.
  
  
  CONCLUSIONS
  These data suggest the need for interventions that address patients' negative perceptions of statins while emphasizing the benefits of statin therapy for reducing cardiovascular morbidity and mortality in formats accessible to those with limited health literacy.
authors.affiliation: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA 91101, USA.
authors.forename: Teressa N
authors.initials: TN
authors.lastname: Harrison
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Derose
authors.forename: T Craig
authors.initials: TC
authors.lastname: Cheetham
authors.forename: Vicki
authors.initials: V
authors.lastname: Chiu
authors.forename: Southida S
authors.initials: SS
authors.lastname: Vansomphone
authors.forename: Kellie
authors.initials: K
authors.lastname: Green
authors.forename: Kaan
authors.initials: K
authors.lastname: Tunceli
authors.forename: Ronald D
authors.initials: RD
authors.lastname: Scott
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Marrett
authors.forename: Kristi
authors.initials: K
authors.lastname: Reynolds
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D036301:Qualitative Research
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors