title: Associations between patients' adherence and GPs' attitudes towards risk, statin therapy and management of non-adherence--a survey and register-based study.
abstract: BACKGROUND
  Previous studies suggest that doctors' personal lifestyle, risk taking personality and beliefs about risk reducing therapies may affect their clinical decision-making. Whether such factors are further associated with patients' adherence with medication is largely unknown.
  
  
  OBJECTIVE
  To estimate associations between GPs' attitudes towards risk, statin therapy and management of non-adherence and their patients' adherence, and to identify subgroups of GPs with poor patient adherence.
  
  
  METHODS
  All Danish GPs were invited to participate in an online survey. We asked whether they regarded statin treatment as important, how they managed non-adherence and whether non-adherence annoyed them. The Jackson Personality Inventory-revised was used to measure risk attitude. The GPs' responses were linked to register data on their patients' redeemed statin prescriptions. Mixed effect logistic regression was used to estimate associations between patient adherence and GPs' attitudes. Adherence was estimated by the proportion of days covered in a 1-year period using an 80% cut-off.
  
  
  RESULTS
  We received responses from 1398 GPs (42.2%) who initiated statin therapy in 12 192 patients during the study period. In total 6590 (54.1%) of these patients were adherent. Patients who had GPs rarely assessing their treatment adherence were less likely to be adherent than those who had GPs assessing their patients' treatment adherence now and then, odds ratio (OR) 0.86 [confidence interval (CI) 0.77-0.96]. No other associations were found between patients' adherence and GPs' attitudes.
  
  
  CONCLUSIONS
  Our findings suggest that GPs' attitudes to risk, statin therapy or management of non-adherence are not significantly associated with their patients' adherence.
authors.affiliation: Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark, bbarfoed@health.sdu.dk.
authors.forename: Benedicte L
authors.initials: BL
authors.lastname: Barfoed
authors.affiliation: Danish Quality Unit of General Practice, Odense, Denmark.
authors.forename: Maja S
authors.initials: MS
authors.lastname: Paulsen
authors.affiliation: General Practitioners Lærkevej, Otterup, Denmark.
authors.forename: Palle M
authors.initials: PM
authors.lastname: Christensen
authors.affiliation: Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway and.
authors.forename: Peder A
authors.initials: PA
authors.lastname: Halvorsen
authors.affiliation: Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.
authors.forename: Dorte E
authors.initials: DE
authors.lastname: Jarbøl
authors.affiliation: Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Mogens L
authors.initials: ML
authors.lastname: Larsen
authors.affiliation: Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.
authors.forename: Maria R
authors.initials: MR
authors.lastname: Munch
authors.affiliation: Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.
authors.forename: Jens
authors.initials: J
authors.lastname: Søndergaard
authors.affiliation: Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.
authors.forename: Jesper B
authors.initials: JB
authors.lastname: Nielsen
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D020407:Internet; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D015233:Models, Statistical; D012042:Registries; D012309:Risk-Taking; D011795:Surveys and Questionnaires
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Cholesterol/lipids; doctor-patient relationship; patient adherence; primary care; risk assessment.