Persistence and adherence to cholesterol lowering agents: Evidence from Regie de l'Assurance Maladie du Ouebec data

Background There is a concern that poor compliance to cholesterol lowering agents (CLA) may compromise their potential benefits. The objective of this study was to estimate compliance to CLAs, in the context of clinical practice in Quebec. Methods This study was performed using data from the Regie de l'Assurance Maladie du Quebec Persistence and adherence to treatment were estimated separately. An index combining these 2 measures was also calculated. Results In a random sample of patients (n = 428304) from the Regie de l'Assurance Maladie du Quebec administrative database, 14076 were new users of a CLA. After 24 months, the persistence rate with the statins was significantly higher than with other CLAs (83% vs 69%; P <.001). The proportion of patients who switched from their initial statin varied across the statins (ranging from 7% to 34%). The proportion of patients who were 80% adherent to their treatment was significantly lower with the other CLA than with statins (43% vs 60%, P <.001). A composite index combining monthly persistence. and adherence was calculated. This index was significantly higher for atorvastatin than for the other CLAs (P <.001) and the other statins (P <.01), with the exception of simvastatin (P =.09). Conclusions Over a 2-year period, a large proportion of patients using a statin remained persistent to treatment. The overall rate of compliance (persistence and adherence) after 2 years was > 60% with some statins.