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Compliance with lipid altering medications and recommended lifestyle changes

Robert S Rosenson, MD
Lynne T Braun, PhD, RN, CNP
Section Editors
Mason W Freeman, MD
Bernard J Gersh, MB, ChB, DPhil, FRCP, MACC
Deputy Editor
Gordon M Saperia, MD, FACC


Nonadherence to evidence-based pharmacotherapy is associated with excess morbidity and mortality [1,2]. The importance of compliance with lipid-altering medications in patients with dyslipidemia was demonstrated in a post-hoc analysis of data from the West of Scotland Coronary Prevention Study (WOSCOPS) [3]. In this primary prevention study of men with hypercholesterolemia, pravastatin therapy was shown to decrease cardiovascular morbidity and mortality (figure 1). (See "Clinical trials of cholesterol lowering for primary prevention of coronary heart disease".)

The mean adherence for the entire group was 70 percent. Those patients in the treatment group with more than 75 percent adherence had the following benefits:

Fewer definite coronary events (risk reduction of 38 versus 31 percent compared with patients treated with placebo)

Lower cardiovascular mortality (risk reduction of 37 versus 32 percent)

This dose-response effect associated with better adherence argues for improving medication adherence to maximize therapeutic response. Other benefits of adherence to drug therapy may include decreased utilization of medical services, better quality of life, and reduced social costs such as lost productivity [4].


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Literature review current through: Sep 2016. | This topic last updated: Jan 29, 2016.
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