Skip to main content

Advertisement

SpringerLink
Log in

Evaluation of the prescription and utilization patterns of statins in an Italian local health unit during the period 1994–2003

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Objectives

The prescription pattern of statins in the Local Health Unit (LHU) of Treviso (northern Italy) over a 10-year period was evaluated, with the aim of evaluating the persistence with and adherence to therapy.

Methods

Data on 21,393 subjects who received at least one prescription for statins during the period between January 1, 1994 and December 31, 2003 were retrieved from the LHU database in order to track the pharmacological history of individual patients. The data included age, sex, drug formulation, strength, number of drug packages prescribed, and prescription date. The adopted indicators for drug utilization included the Defined Daily Dose (DDD), the Received Daily Dose (RDD), and a surrogated Prescribed Daily Dose (sPDD), extrapolated from available prescription data. An Adherence to Therapy Index (ATI) was calculated from the ratio between the amount of drug actually prescribed and the amount of sPDD. Based on the ATI, patients were grouped into non-adherent, poor-adherent, and good-adherent groups. The distribution of adherence level among patient-age classes and statin-prescribed patients in primary or secondary prevention was evaluated.

Results

All drug-utilization indicators showed an increase in statin use over the study period in terms of both the number of prescribed patients and the sPDD. Persistence with and adherence to therapy remained low, with a 50% discontinuation rate in the first year, and persistent patients did not follow the therapy regularly. Patients in secondary prevention were the most adherent to their drug regimen, although only 41% of these had a good compliance.

Conclusions

Our findings suggest an increase in statin use which is, however, accompanied by poor patient persistence with and adherence to statin therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Pignone M, Phillips C, Mulrow C (2000) Use of lipid lowering drugs for primary prevention of coronary artery disease: metanalysis of randomized clinical trials. Br Med J 321:983–986

    Article  CAS  Google Scholar 

  2. Hebert PR, Gaziano M, Chan KS, Hennekens CH (1997) Cholesterol lowering with statin drugs, risk of stroke, and total mortality. An overview of randomized trials. JAMA 287:313–321

    Article  Google Scholar 

  3. Avorn J, Monette J, Lacour A, Bohn RL, Monane M, Mogun H, LeLorier J (1998) Persistence of use of lipid-lowering medications: a cross-national study. JAMA 279:1458–1462

    Article  PubMed  CAS  Google Scholar 

  4. Larsen J, Vaccheri A, Andersen M, Montanaro N, Bergman U (2000) Lack of adherence to lipid lowering drug treatment. A comparison of utilization patterns in defined population in Funen, Denmark, and Bologna, Italy. Br J Clin Pharmacol 49:463–471

    Article  PubMed  CAS  Google Scholar 

  5. Walley T, Folino-Gallo P, Stephens P, Van Ganse E (2005) On behalf of the EuroMedStat group. Trends in prescribing and utilization of statins and other lipid lowering drugs across Europe 1997–2003. Br J Clin Pharmacol 60:543–551

    Article  PubMed  CAS  Google Scholar 

  6. Ministero della Salute (2003) L’uso dei farmaci in Italia: rapporto nazionale anno 2003. Il Pensiero Scientifico Editore, Rome, pp 82–86

  7. World Health Organization Collaborating Centre for Drug Statistics Methodology (2000) ATC Index with DDDs. WHO, Oslo

    Google Scholar 

  8. Mitka M (2003) Expanding statin use to help more at-risk patients is causing financial heartburn. JAMA 290:2243–2245

    Article  PubMed  CAS  Google Scholar 

  9. Genest J, Frohlich J, Fodor G, McPherson R, Working Group on Hypercholesterolemia and Other Dyslipidemias (2003) Recommendations for the management of dyslipidemia and the prevention of cardiovascular disease: summary of the 2003 update. Can Med Assoc J 169:921–924

    Google Scholar 

  10. De Ambrosis P, Saramin C, Terrazzani G, Scaldaferri E, Giusti P, Chinellato A (2005) Ten years of statin utilization: adherence to therapy and cost of treatment. Pharmacoeconomics 7:187–194

    Google Scholar 

  11. Chinellato A, Terrazzani G, Debetto P, Zambon P, Guzzinati S, Walley T, Giusti P (2006) Retrospective analysis of opioid prescriptions in cancer patients in a northern Italian Region. Br J Clin Pharmacol 62:130–133

    Google Scholar 

  12. Wald NJ, Law MR (2003) A strategy to reduce cardiovascular disease by more than 80%. Br Med J 326:1419–1422

    Article  CAS  Google Scholar 

  13. Baigent C, Keech A, Kearney PM, Blackwell L, Buck G, Pollicino C, Kirby A, Sourjina T, Peto R, Collins R, Simes R, Cholesterol Treatment Trialists’ (CTT) Collaborators (2005) Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet 366:1267–1278

    Article  PubMed  CAS  Google Scholar 

  14. Schwandt P, Brady AJ (2004) Achieving lipid goals in Europe: how large is the treatment gap? Expert Rev Cardiovasc Ther 2:431–439

    Article  PubMed  Google Scholar 

  15. Simons LA, Levis G, Simons J (1996) Apparent discontinuation rates in patients prescribed lipid-lowering drugs. Med J Aust 164:208–211

    PubMed  CAS  Google Scholar 

  16. Eriksson M, Hadell K, Holme I et al (1998) Adherence with and efficacy of treatment with pravastatin and cholestyramine: a randomized study on lipid lowering in primary care. J Intern Med 243:373–380

    Article  PubMed  CAS  Google Scholar 

  17. Perreault S, Blais L, Dragomir A, Bouchard MH, Lalonde L, Laurier C, Collin J (2005) Persistence and determinants of statin therapy among middle-aged patients for primary and secondary prevention. Br J Clin Pharmacol 59:564–573

    Article  PubMed  CAS  Google Scholar 

  18. Hugtenburg JG, Blom AT, Kisoensingh SU (2006) Initial phase of chronic medication use; patients’ reasons for discontinuation. Br J Clin Pharmacol 61:352–354

    Article  PubMed  CAS  Google Scholar 

  19. Morrison A, Glassberg H (2003) Determinants of the cost-effectiveness of statins. J Manag Care Pharm 9:544–551

    PubMed  Google Scholar 

  20. Urquhart J (1999) Pharmacoeconomic consequences of variable patient compliance with prescribed drug regimens. Pharmacoeconomics 15:217–228

    Article  PubMed  CAS  Google Scholar 

  21. Peterson AM, McGhan WF (2005) Pharmacoeconomic impact of non-compliance with statins. Pharmacoeconomics 23:13–25

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank Dr. Ennio Scaldaferri and Dr. Silvia Chiroli for their helpful comments on the paper. This study has been supported by a Grant from Regione Veneto. DRG n. 4034, December, 20, 2005.

Author information

Authors and Affiliations

  1. Pharmaceutical Service, Local Health Authority (ULSS 9), Treviso, Italy

    Paola Deambrosis, Cristina Saramin, Gianni Terrazzani & Alessandro Chinellato

  2. Antidiabetic Unit, Local Health Authority (ULSS 9), Treviso, Italy

    Luca Scaldaferri

  3. Department of Pharmacology and Anesthesiology, University of Padova, Largo “E. Meneghetti” 2, 35131, Padova, Italy

    Patrizia Debetto & Pietro Giusti

Authors
  1. Paola Deambrosis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cristina Saramin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gianni Terrazzani
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Luca Scaldaferri
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Patrizia Debetto
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Pietro Giusti
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Alessandro Chinellato
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pietro Giusti.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Deambrosis, P., Saramin, C., Terrazzani, G. et al. Evaluation of the prescription and utilization patterns of statins in an Italian local health unit during the period 1994–2003. Eur J Clin Pharmacol 63, 197–203 (2007). https://doi.org/10.1007/s00228-006-0239-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00228-006-0239-3

Keywords

Search

Navigation