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CVS: Demographics influence adherence

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WOONSOCKET, R.I. — Women and nonwhites taking statins are more likely to be nonadherent than other patient groups, recent research from CVS Caremark Corp. and Brigham and Women’s Hospital shows.

In a report published in the May issue of The American Heart Journal, researchers say that nonwhite patients had 50% greater odds of statin medication nonadherence compared to white patients, while women had 10% greater odds of statin nonadherence compared to men.

“These findings help us better understand the impact of certain demographic factors on medication adherence,” Dr. Niteesh Choudhry, an professor at Harvard Medical School and a physician in the hospital’s division of pharmacoepidemiology and pharmacoeconomics.

“Since a large number of patients depend on medication therapy for primary and secondary prevention of cardiovascular disease, we believe that efforts to reduce nonadherence for statins can have a significant effect on addressing health care disparities, improving health outcomes and ultimately reducing costs,” he says.

The CVS Caremark-Brigham and Women’s study looked at previous studies in more than 50 publications that focused on gender and racial disparities associated with medication adherence. The literature the researchers reviewed involved research done on more than 1.7 million patients.

The researchers say it is noteworthy that the finding that nonadherence was higher based on the patient’s gender or race held true even in studies that adjusted for income, insurance status, co-payment amounts and other clinically important factors that could contribute to nonadherence.

“This research helps those of us in the health care field better understand how to improve our outreach to patients who may be at a higher risk of nonadherence and develop programs to help these patients improve their medication adherence,” CVS Caremark executive vice president and chief medical officer Troy Brennan says.

The researchers say that there are a number of potential reasons for nonadherence among women and nonwhite patients. For example, they note, active prevention of cardiovascular disease may not be a priority for women and their health care providers because of the common misconception that women are less at risk than men.

In addition, they say, women also frequently serve as informal caregivers for family members and often neglect their own well-being.

Researchers say the reasons that nonwhite patients may be nonadherent are more complex. Nonwhite patients, they note, are often less likely to have a consistent relationship with a primary care provider than white patients, which can impact chronic care and ­adherence.

The researchers say that part of the problem for women and nonwhites is physiological, as both groups may be more likely to experience side effects from statins, causing them to discontinue taking the medication.


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