title: Maintenance of statin use over 3 years following acute coronary syndromes: a national data linkage study (ANZACS-QI-2).
abstract: OBJECTIVE
  To describe patterns of statin use and predictors of poor maintenance over a 3-year period following an acute coronary syndrome (ACS).
  
  
  METHODS
  National hospitalisation, mortality and pharmaceutical dispensing data were linked for all subjects aged 35-84 years discharged from a public hospital with an ACS in New Zealand in 2007. A Medication Possession Ratio (MPR; percentage of follow-up days patients were dispensed statins) was calculated for each patient. Adequate maintenance was defined by a MPR ≥80%.
  
  
  RESULTS
  In 2007, 11 348 patients aged 35-84 years were discharged from hospital with ACS. Within 90 days of discharge, 83% had received a statin. Over the follow-up period, 66% were adequately maintained on a statin (MPR ≥80%): 69% in the first year, 67% in the second year and 66% in the third year. Patients taking statins prior to admission and those who underwent a coronary procedure were 20-50% more likely to have a MPR ≥80% over 3 years than others. In contrast, people aged 35-45 years and those of Maori or Pacific ethnicity were 13-25% less likely to have a MPR ≥80% than those aged 55-64 years and Europeans.
  
  
  CONCLUSIONS
  One-third of patients were not adequately maintained on statins over the 3-year period following ACS, but 82% of those on a statin prior to admission had an MPR ≥80% over 3 years of follow-up. These findings define achievable treatment levels and identify groups who may benefit from efforts to improve statin use.
authors.affiliation: Section of Epidemiology and Biostatistics, University of Auckland, , Auckland, New Zealand.
authors.forename: Corina
authors.initials: C
authors.lastname: Grey
authors.forename: Rod
authors.initials: R
authors.lastname: Jackson
authors.forename: Sue
authors.initials: S
authors.lastname: Wells
authors.forename: Simon
authors.initials: S
authors.lastname: Thornley
authors.forename: Roger
authors.initials: R
authors.lastname: Marshall
authors.forename: Sue
authors.initials: S
authors.lastname: Crengle
authors.forename: Jeff
authors.initials: J
authors.lastname: Harrison
authors.forename: Tania
authors.initials: T
authors.lastname: Riddell
authors.forename: Andrew
authors.initials: A
authors.lastname: Kerr
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000401:mortality; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death / Q000639:trends; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors