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Reasons for Nonadherence to Statins – A Systematic Review of Reviews

Authors Ingersgaard MV, Helms Andersen T, Norgaard O, Grabowski D, Olesen K

Received 10 January 2020

Accepted for publication 4 March 2020

Published 2 April 2020 Volume 2020:14 Pages 675—691


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Marianne Vie Ingersgaard,1 Tue Helms Andersen,2 Ole Norgaard,2 Dan Grabowski,1 Kasper Olesen1

1Health Promotion, Steno Diabetes Center Copenhagen, Gentofte, Denmark; 2Education Department, Steno Diabetes Center Copenhagen, Gentofte, Denmark

Correspondence: Marianne Vie Ingersgaard
Health Promotion, Steno Diabetes Center Copenhagen, Niels Steensens Vej 6, Gentofte 2820, Denmark
Tel +45 91 17 48 35

Purpose: Lipid-lowering medications are often prescribed to decrease the risk of micro- and macro-cardiovascular complications related to dyslipidaemia. Despite widespread prescription of lipid-lowering drugs, including statins, adherence to therapy is a challenge worldwide. This systematic review of reviews aimed to conduct a critical appraisal and synthesis of review findings and to provide an overview of the factors that were found to affect adherence to lipid-lowering drugs, focusing on statins, in the reviews.
Patients and Methods: A systematic review methodology was used. MEDLINE, Embase, and Epistemonikos databases were searched for relevant publications. AMSTAR 2 criteria were used to assess the quality of the selected publications.
Results: From a total of 763 screened publications, 9 met all inclusion criteria and were included in this synthesis. Several factors were identified as being associated with adherence to lipid-lowering agents. Among them, high socio-economic and educational position, and middle age had a positive effect on adherence to lipid-lowering agents. Contrary, female sex, older and younger age, non-white race, low socio-economic position, high co-payments, being a new statin user, comorbidities, side effects, regimen complexity, type and intensity of statin dose, smoking, alcohol consumption, imperceptible benefits, and medical distrust contributed to non-adherence. The overall quality of the included reviews was considered critically low to moderate.
Conclusion: This review of reviews has evaluated the impact of factors on adherence statins. Further research related to modifiable predictors for non-adherence is warranted.

Keywords: nonadherence, adherence, statins, dyslipidaemia, lipid-lowering drugs, review

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