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Adherence to lipid-lowering treatment: the patient perspective

Authors Casula M, Tragni E, Catapano A

Received 18 September 2012

Accepted for publication 11 October 2012

Published 8 November 2012 Volume 2012:6 Pages 805—814


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Manuela Casula,1 Elena Tragni,1 Alberico Luigi Catapano1,2

Epidemiology and Preventive Pharmacology Centre (SEFAP), Department of Pharmacological Sciences, University of Milan, Milan, Italy; 2IRCCS MultiMedica, Sesto San Giovanni, Italy

Abstract: Despite the widespread prescription of highly effective lipid-lowering medications, such as the HMG-CoA reductase inhibitors (statins), a large portion of the population has lipid levels higher than the recommended goals. Treatment failures have been attributed to a variety of causes but the most important is likely to be poor adherence to therapy in the form of irregular or interrupted intake and the high frequency of discontinuation or lack of persistence. Adherence is a multidimensional phenomenon determined by the interplay of patient factors, physician factors, and health care system factors. Patients' knowledge and beliefs about their illness, motivation to manage it, confidence in their ability to engage in illness-management behaviors, and expectations regarding the outcome of treatment and the consequences of poor adherence interact to influence adherence behavior. Patient-related factors account for the largest incremental explanatory power in predicting adherence. This article provides an overview of this critical issue, focusing on patient role in determining adherence level to lipid-lowering therapy.

Keywords: hyperlipidemia/drug therapy, medication adherence, patient preference, health behavior

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