title: Patient-related characteristics associated with non-persistence with statin therapy in elderly patients following an ischemic stroke.
abstract: This study was aimed at evaluating the extent of non-persistence with statin therapy in elderly patients after an ischemic stroke and identifying patient-related characteristics that are risk factors for non-persistence.
  
  
  
  The evaluable study cohort (n = 2748) was derived from the database of the largest health insurance provider in the Slovak Republic. Patients aged ≥65 years who were initiated on statin therapy following the diagnosis of an ischemic stroke during one full year (1 January 2010 to 31 December 2010) constituted this cohort. Each patient was followed for a period of 3 years from the date of the first statin prescription. Patients with a continuous treatment gap of 6 months without statin prescription were designated as non-persistent. The Cox proportional hazard model was applied to determine patient-associated characteristics that influenced the likelihood of non-persistence.
  
  
  
  During the 3-year follow-up period, 39.7% of patients in the study cohort became non-persistent. Factors associated with decreased probability of a patient becoming non-persistent were age ≥75 years (hazard ratio (HR) 0.75), polypharmacy (concurrent use of ≥6 drugs) (HR 0.79), diabetes mellitus (HR 0.80), dementia (HR 0.81) and hypercholesterolemia (HR 0.50). On the other hand, the presence of anxiety disorders (HR 1.33) predicted an increased likelihood of a patient being non-persistent.
  
  
  
  Our findings suggest that patients aged ≥75 years or those with the presence of diabetes mellitus, dementia, hypercholesterolemia or polypharmacy were likely to be persistent with statin therapy, whereas those with anxiety disorders may need greater assistance with persistence of statin therapy. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Institute of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Comenius University, Bratislava, Slovakia.
authors.forename: Martin
authors.initials: M
authors.lastname: Wawruch
authors.affiliation: General Health Insurance Company, Bratislava, Slovakia.
authors.forename: Dusan
authors.initials: D
authors.lastname: Zatko
authors.affiliation: Institute of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Comenius University, Bratislava, Slovakia.
authors.forename: Gejza
authors.initials: G
authors.lastname: Wimmer
authors.affiliation: Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University, Bratislava, Slovakia.
authors.forename: Jan
authors.initials: J
authors.lastname: Luha
authors.affiliation: Institute of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Comenius University, Bratislava, Slovakia.
authors.forename: Vasil
authors.initials: V
authors.lastname: Hricak
authors.affiliation: First Department of Internal Medicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia.
authors.forename: Jan
authors.initials: J
authors.lastname: Murin
authors.affiliation: Second Department of Neurology, Faculty of Medicine, Comenius University, Bratislava, Slovakia.
authors.forename: Peter
authors.initials: P
authors.lastname: Kukumberg
authors.affiliation: Department of Organisation and Management of Pharmacy, Faculty of Pharmacy, Comenius University, Bratislava, Slovakia.
authors.forename: Tomas
authors.initials: T
authors.lastname: Tesar
authors.affiliation: Ministry of Health of the Slovak Republic, Bratislava, Slovakia.|Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University, Bratislava, Slovakia.
authors.forename: Adam
authors.initials: A
authors.lastname: Hloska
authors.affiliation: Gerrards Cross, UK.
authors.forename: Rashmi
authors.initials: R
authors.lastname: Shah
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000453:epidemiology; D002545:Brain Ischemia / Q000188:drug therapy*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008297:Male; D019338:Polypharmacy; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D018154:Slovakia; D020521:Stroke / Q000188:drug therapy*; D016903:Drug Monitoring
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: anxiety disorders; diabetes mellitus; hypercholesterolemia; persistence; statin; stroke