Observational studyCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2014
Lifestyle factors as predictors of nonadherence to statin therapy among patients with and without cardiovascular comorbidities.
Observational study in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2014. The graph read 6 numbers from its abstract, feeding 3 cells of the map, but none could be read as for or against, so it casts no vote. It also reports 6 associations that do not count as treatment evidence, such as OR 0.82 (0.74 to 0.92) for body weight & composition. Cited by 18 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
Read, but not usablea number the graph found but could not read as for or against
Obesity (adjusted odds ratio [OR] 0.86, 95% confidence interval [CI] 0.74-0.99), overweight (adjusted OR 0.88, 95% CI 0.79-0.98) and former smoking (adjusted OR 0.82, 95% CI 0.74-0.92) predicted a reduced risk of nonadherence in this group after adjustment for sex, age and year of statin initiation.
Obesity (adjusted odds ratio [OR] 0.86, 95% confidence interval [CI] 0.74-0.99), overweight (adjusted OR 0.88, 95% CI 0.79-0.98) and former smoking (adjusted OR 0.82, 95% CI 0.74-0.92) predicted a reduced risk of nonadherence in this group after adjustment for sex, age and year of statin initiation.
Obesity (adjusted odds ratio [OR] 0.86, 95% confidence interval [CI] 0.74-0.99), overweight (adjusted OR 0.88, 95% CI 0.79-0.98) and former smoking (adjusted OR 0.82, 95% CI 0.74-0.92) predicted a reduced risk of nonadherence in this group after adjustment for sex, age and year of statin initiation.
In this group, high alcohol consumption (adjusted OR 1.55, 95% CI 1.12-2.15), extreme drinking occasions (adjusted OR 1.48, 95% CI 1.11-1.97) and a cluster of 3-4 lifestyle risks (adjusted OR 1.61, 95% CI 1.15-2.27) predicted increased odds of nonadherence after adjustment for sex, age and year of statin initiation.
In this group, high alcohol consumption (adjusted OR 1.55, 95% CI 1.12-2.15), extreme drinking occasions (adjusted OR 1.48, 95% CI 1.11-1.97) and a cluster of 3-4 lifestyle risks (adjusted OR 1.61, 95% CI 1.15-2.27) predicted increased odds of nonadherence after adjustment for sex, age and year of statin initiation.
In this group, high alcohol consumption (adjusted OR 1.55, 95% CI 1.12-2.15), extreme drinking occasions (adjusted OR 1.48, 95% CI 1.11-1.97) and a cluster of 3-4 lifestyle risks (adjusted OR 1.61, 95% CI 1.15-2.27) predicted increased odds of nonadherence after adjustment for sex, age and year of statin initiation.
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Where it lands on the map
Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.
What it adds to each cell
For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.
Diet, exercise & lifestyle×quality of life & behaviour
No readable resultOpen on the map →What to test next →No other readable study in this cell yet. This paper is the evidence.
Statins×body weight & composition
No readable resultOpen on the map →What to test next →2 readable studies in this cell: 1 favour the treatment, 1 find no difference, 0 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
Statins×quality of life & behaviour
No readable resultOpen on the map →What to test next →3 readable studies in this cell: 0 favour the treatment, 3 find no difference, 0 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Prevalence and predictors of medication non-adherence among people living with multimorbidity: a systematic review and meta-analysis.BMJ open · 2021Pooled it
- Systematic review of the predictors of statin adherence for the primary prevention of cardiovascular disease.PloS one · 2019Pooled it
- Tailored interventions by community pharmacists and general practitioners improve adherence to statins in a Spanish randomized controlled trial.Health services research · 2019Trial
- Level of medication non-adherence among ambulatory patients with dyslipidemia and comorbid illness in Northwest Ethiopia: a multicenter cross-sectional study.Therapeutic advances in chronic disease · 2025Article
- Clinical Characteristics of Patients With Statin Discontinuation in Korea: A Nationwide Population-Based Study.Journal of lipid and atherosclerosis · 2024Article
- Adherence to Statin Therapy and Attainment of LDL Cholesterol Targets in an Outpatient Population of Type 2 Diabetes Patients: Analysis in the DIAbetes and LifEstyle Cohort Twente (DIALECT).Frontiers in pharmacology · 2022Article
- Observational
- Determinants of Non-Adherence to the Medications for Dyslipidemia: A Systematic Review.Patient preference and adherence · 2021Review
- Initiation and Single Dispensing in Cardiovascular and Insulin Medications: Prevalence and Explanatory Factors.International journal of environmental research and public health · 2020Article
- Effectiveness of mailed letters to improve medication adherence among Medicare Advantage Plan participants with chronic conditions.Patient preference and adherence · 2019Article
- Adherence Tradeoff to Multiple Preventive Therapies and All-Cause Mortality After Acute Myocardial Infarction.Journal of the American College of Cardiology · 2017Article
- Measuring medication adherence in patients with incident hypertension: a retrospective cohort study.BMC health services research · 2017Article
- Article
- Discontinuation and restarting in patients on statin treatment: prospective open cohort study using a primary care database.BMJ (Clinical research ed.) · 2016Article
- Article
- Influence of baseline low-density lipoprotein cholesterol values on statin therapy persistence.European journal of clinical pharmacology · 2016Article
- Influence of Retirement on Adherence to Statins in the Insurance Medicine All-Sweden Total Population Data Base.PloS one · 2015Article
- Predictors of first-year statin medication discontinuation: A cohort study.Journal of clinical lipidologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
The marked sentences are the ones the graph read a number from.
backgroundEasily detectable predictors of nonadherence to long-term drug treatment are lacking. We investigated the association between lifestyle factors and nonadherence to statin therapy among patients with and without cardiovascular comorbidities.
methodsWe included 9285 participants from the Finnish Public Sector Study who began statin therapy after completing the survey. We linked their survey data with data in national health registers. We used prescription dispensing data to determine participants' nonadherence to statin therapy during the first year of treatment (defined as < 80% of days covered by filled prescriptions). We used logistic regression to estimate the association of several lifestyle factors with nonadherence, after adjusting for sex, age and year of statin initiation.
resultsOf the participants without cardiovascular comorbidities (n = 6458), 3171 (49.1%) were nonadherent with their statin therapy. Obesity (adjusted odds ratio [OR] 0.86, 95% confidence interval [CI] 0.74-0.99), overweight (adjusted OR 0.88, 95% CI 0.79-0.98) and former smoking (adjusted OR 0.82, 95% CI 0.74-0.92) predicted a reduced risk of nonadherence in this group after adjustment for sex, age and year of statin initiation. Of the participants with cardiovascular comorbidities (n = 2827), 1155 (40.9%) were nonadherent. In this group, high alcohol consumption (adjusted OR 1.55, 95% CI 1.12-2.15), extreme drinking occasions (adjusted OR 1.48, 95% CI 1.11-1.97) and a cluster of 3-4 lifestyle risks (adjusted OR 1.61, 95% CI 1.15-2.27) predicted increased odds of nonadherence after adjustment for sex, age and year of statin initiation.
interpretationPeople with cardiovascular comorbidities who had risky drinking behaviours or a cluster of lifestyle risks were at increased risk of nonadherence. Among individuals without cardiovascular comorbidities, information on lifestyle factors was unhelpful in identifying those at increased risk of nonadherence; that overweight, obesity and former smoking were predictors of better adherence in this group provides insight into mechanisms of adherence to preventive medication that deserve further study.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.