title: Associations between patients' risk attitude and their adherence to statin treatment - a population based questionnaire and register study.
abstract: BACKGROUND
  Poor adherence to medical treatment may have considerable consequences for the patients' health and for healthcare costs to society. The need to understand the determinants for poor adherence has motivated several studies on socio-demographics and comorbidity. Few studies focus on the association between risk attitude and adherence. The aim of the present study was to estimate associations between patients' adherence to statin treatment and different dimensions of risk attitude, and to identify subgroups of patients with poor adherence.
  
  
  METHODS
  Population-based questionnaire and register-based study on a sample of 6393 persons of the general. Danish population aged 20-79. Data on risk attitude were based on 4 items uncovering health-related as well as financial dimensions of risk attitude. They were collected through a web-based questionnaire and combined with register data on redeemed statin prescriptions, sociodemographics and comorbidity. Adherence was estimated by proportion of days covered using a cut-off point at 80 %.
  
  
  RESULTS
  For the dimension of health-related risk attitude, "Preference for GP visit when having symptoms", risk-neutral and risk-seeking patients had poorer adherence than the risk-averse patients, OR 0.80 (95 %-CI 0.68-0.95) and OR 0.83 (95 %-CI 0.71-0.98), respectively. No significant association was found between adherence and financial risk attitude. Further, patients in the youngest age group and patients with no CVD were less adherent to statin treatment.
  
  
  CONCLUSIONS
  We find some indication that risk attitude is associated with adherence to statin treatment, and that risk-neutral and risk-seeking patients may have poorer adherence than risk-averse patients. This is important for clinicians to consider when discussing optimal treatment decisions with their patients. The identified subgroups with the poorest adherence may deserve special attention from their GP regarding statin treatment.
authors.affiliation: Research Unit of General practice, Department of Public Health, University of Southern Denmark, JB Winsløws Vej 9A, 5000, Odense C, Denmark. bbarfoed@health.sdu.dk.
authors.forename: Benedicte Lind
authors.initials: BL
authors.lastname: Barfoed
authors.affiliation: Danish Quality Unit of General Practice, JB Winsløws Vej 9A, 5000, Odense C, Denmark. mspausen@dak-e.dk.
authors.forename: Maja Skov
authors.initials: MS
authors.lastname: Paulsen
authors.affiliation: General Practitioners Lærkevej, Lærkevej 14, 5450, Otterup, Denmark. pmchristensen@health.sdu.dk.
authors.forename: Palle Mark
authors.initials: PM
authors.lastname: Christensen
authors.affiliation: Department of Community Medicine, University of Tromsø, The Arctic University of Norway, 9037, Tromsø, Norway. peder.halvorsen@kraftlaget.no.
authors.forename: Peder Andreas
authors.initials: PA
authors.lastname: Halvorsen
authors.affiliation: Centre of Health Economics Research, COHERE, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark. tkj@sam.sdu.dk.
authors.forename: Trine
authors.initials: T
authors.lastname: Kjær
authors.affiliation: Department of Cardiology, Aalborg University Hospital, Sdr. Skovvej 15, 9000, Aalborg, Denmark. mogenslytkenlarsen@dadlnet.dk.
authors.forename: Mogens Lytken
authors.initials: ML
authors.lastname: Larsen
authors.affiliation: Center for Clinical Epidemiology, Odense University Hospital, Sdr Boulevard 29, 5000, Odense C, Denmark. Pia.Veldt.Larsen@rsyd.dk.|Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Sdr. Boulevard 29, 5000, Odense C, Denmark. Pia.Veldt.Larsen@rsyd.dk.
authors.forename: Pia Veldt
authors.initials: PV
authors.lastname: Larsen
authors.affiliation: Research Unit of General practice, Department of Public Health, University of Southern Denmark, JB Winsløws Vej 9A, 5000, Odense C, Denmark. JBNielsen@health.sdu.dk.
authors.forename: Jesper Bo
authors.initials: JB
authors.lastname: Nielsen
authors.affiliation: Research Unit of General practice, Department of Public Health, University of Southern Denmark, JB Winsløws Vej 9A, 5000, Odense C, Denmark. JSoendergaard@health.sdu.dk.
authors.forename: Jens
authors.initials: J
authors.lastname: Søndergaard
authors.affiliation: Research Unit of General practice, Department of Public Health, University of Southern Denmark, JB Winsløws Vej 9A, 5000, Odense C, Denmark. DJarbol@health.sdu.dk.
authors.forename: Dorte Ejg
authors.initials: DE
authors.lastname: Jarbøl
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003718:Denmark; D005260:Female; D058006:General Practice; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D012042:Registries; D012309:Risk-Taking; D011795:Surveys and Questionnaires; D016903:Drug Monitoring
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors