title: Factors associated with 2-year persistence in fully non reimbursed lipid-lowering treatments.
abstract: OBJECTIVE
  to evaluate the main factors associated with long-term persistence in fully paid lipid-lowering treatment.
  
  
  METHODS
  We selected 628 moderately hypercholesterolemic subjects (M: 307; F: 311, mean age 59 ± 9 years old), to whom we firstly prescribed a statin (N. 397) or different kinds of lipid-lowering nutraceuticals (N. 231). Then, depending on their will, patients took brand statin (N. 194) or generic statins (N. 203).
  
  
  RESULTS
  The main determinants of long-term persistence in therapy are female sex (OR 1.21, 95%CI 1.08-1.42), family history of early cardiovascular disease (OR 1.31, 95%CI 1.13-1.49), baseline LDL-C (OR 1.19, 95%CI 1.02-1.33) and treatment with nutraceuticals versus statins (OR 1.29, 95%CI 1.14-1.38). Persistence appears not to be influenced by patient's age, smoking habit, adverse events during treatment, and estimated cardiovascular risk.
  
  
  CONCLUSIONS
  Among self-paying patients with mild hyperlipidemia, medication persistence is highest among those taking nutraceuticals, followed by brand statins, followed by generic statins.
authors.affiliation: Medicine and Surgery Sciences Department, University of Bologna, S. Orsola-Malpighi University Hospital, Via Albertoni, 15, 40138 Bologna, Italy. Electronic address: arrigo.cicero@unibo.it.
authors.forename: Arrigo F G
authors.initials: AF
authors.lastname: Cicero
authors.affiliation: Internal Medicine and Therapeutics Department, University of Bologna, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Derosa
authors.affiliation: Medicine and Surgery Sciences Department, University of Bologna, S. Orsola-Malpighi University Hospital, Via Albertoni, 15, 40138 Bologna, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Parini
authors.affiliation: Medicine and Surgery Sciences Department, University of Bologna, S. Orsola-Malpighi University Hospital, Via Albertoni, 15, 40138 Bologna, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Baronio
authors.affiliation: Medicine and Surgery Sciences Department, University of Bologna, S. Orsola-Malpighi University Hospital, Via Albertoni, 15, 40138 Bologna, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Borghi
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000517:prevention & control; D015331:Cohort Studies; D019587:Dietary Supplements; D016568:Drugs, Generic; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000188:drug therapy*; D007356:Insurance, Pharmaceutical Services; D008055:Lipids / Q000097:blood; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D015999:Multivariate Analysis
chemical_list: D016568:Drugs, Generic; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids
keywords: Nutraceuticals; Persistence; Reimbursement; Statin