title: A simple informative intervention in primary care increases statin adherence.
abstract: OBJECTIVE
  To assess the effectiveness of an informative intervention on general practitioners aimed at improving patients' adherence to statin therapy.
  
  
  METHODS
  In the local health unit (LHU) of Bergamo, Lombardy (Italy), each general practitioner received a synthetic scientific document on dyslipidaemia and statins and aggregated data on adherence in 2006 for his/her patients compared to the means in the LHU and in his/her working district. Furthermore, a sample of seven districts received also a table of adherence levels for single patients. Patient's level data were retrieved from the health care utilisation databases of the LHU. Adherence parameters (proportion of patients with only one prescription, medication possession ratio [MPR] and proportion of non-persistent patients) were assessed after 1 year of follow-up.
  
  
  RESULTS
  Overall, 5833 and 4788 new statin users were enrolled before and after the intervention, respectively. The percentage of patients with only one prescription decreased from 28.0 to 23.9 % (p < 0.001). MPR increased from 70.3 to 76.0 % (p < 0.001), and proportion of patients with MPR ≥ 80 % increased from 45.4 to 56.4 % (p < 0.001). The persistence also showed an improvement, both in terms of decreasing proportion of non-persistent (from 51.9 to 41.4 %, p < 0.001) and of increasing duration of continued therapy (from 235 to 264 mean days of persistent therapy, p < 0.001). There were not significant differences between the two types of intervention.
  
  
  CONCLUSIONS
  This intervention resulted in an overall improvement of the short-term adherence to therapy. This tool can be replicated in other local contexts and with other chronic therapies.
authors.affiliation: Epidemiology and Preventive Pharmacology Centre (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Balzaretti 9, 20133, Milan, Italy. sefap@unimi.it.
authors.forename: Manuela
authors.identifier: http://orcid.org/0000-0002-5124-5361
authors.initials: M
authors.lastname: Casula
authors.affiliation: Epidemiology and Preventive Pharmacology Centre (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Balzaretti 9, 20133, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Tragni
authors.affiliation: Local Pharmaceutical Service, LHU of Bergamo, via Gallicciolli 4, 24121, Bergamo, Italy.
authors.forename: Rossana
authors.initials: R
authors.lastname: Piccinelli
authors.affiliation: Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, University of Milano-Bicocca, Via Bicocca degli Arcimboldi 8, 20126, Milan, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Zambon
authors.affiliation: Local Pharmaceutical Service, LHU of Bergamo, via Gallicciolli 4, 24121, Bergamo, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: De Fendi
authors.affiliation: Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, University of Milano-Bicocca, Via Bicocca degli Arcimboldi 8, 20126, Milan, Italy.
authors.forename: Lorenza
authors.initials: L
authors.lastname: Scotti
authors.affiliation: Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, University of Milano-Bicocca, Via Bicocca degli Arcimboldi 8, 20126, Milan, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Corrao
authors.affiliation: Local Pharmaceutical Service, LHU of Bergamo, via Gallicciolli 4, 24121, Bergamo, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Gambera
authors.affiliation: Epidemiology and Preventive Pharmacology Centre (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Balzaretti 9, 20133, Milan, Italy.|IRCCS MultiMedica, via Milanese 300, 20099 Sesto S. Giovanni, Milan, Italy.
authors.forename: Alberico Luigi
authors.initials: AL
authors.lastname: Catapano
authors.affiliation: Italian Society of General Medicine (SIMG), Via del Pignoncino 9-11, 50142, Florence, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Filippi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050171:Dyslipidemias / Q000188:drug therapy*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011320:Primary Health Care; D016903:Drug Monitoring
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Adherence; General practice; Informative intervention; Persistence; Statin therapy