Registry finds most willing to try again
Statin eligible patients who aren't on one were mostly willing to accept a prescription if offered, according to a survey of registry participants.
Among the 1,511 such adults surveyed, 59.2% said they had never been offered a statin, Corey Bradley, MD, of Duke Clinical Research Institute in Durham, North Carolina, and colleagues reported.
But 67.7% of those not offered a statin reported being willing to take one in the findings published in the Journal of the American Heart Association.
Another 30.7% said they had been offered a statin but discontinued it. Among them, 59.7% said they would consider retrying a statin again.
"Fear of side effects and perceived side effects were the most common reasons cited for declining or discontinuing a statin," Bradley's group noted.
Participants who reported having declined or discontinued statins were less likely than current users in the same registry to believe statins are safe (36.9% and 37.4%, respectively, vs 70.4%) or effective (67.4% and 69.1% vs 86.3%).
"Although we were unable to determine the degree to which patients' decisions to decline statin therapy were related to factual versus incorrect beliefs about statin safety," the researchers noted, "misperceptions about statins are common; >1 in 4 adults in [the survey] believed that statins can cause memory loss, including 27.1% of those currently on statins. Efforts to improve statin uptake should include resources for clinicians to accurately describe the risks of statin therapy while combating misperceptions and addressing patient fears about medication."
The findings weren't surprising, but should make physicians more motivated to have those conversations, commented Howard Weintraub, MD, of the NYU Center for the Prevention of Cardiovascular Disease in New York City.
"They fit with my expectations in that there is maybe inadequate communication between patients and physicians," he told MedPage Today. "We see this. We see people who come in thinking they are statin intolerant after having tried only one drug or people who think they are statin intolerant but their symptoms are not drug related."
In total, 5,693 adults who would have been recommended for statin therapy under 2013 national guidelines were included in the PALM (Patient and Provider Assessment of Lipid Management) registry of U.S. patients from 140 cardiology, primary care, and endocrinology practices.
Overall, 26.5% were not on a statin. In multivariate analysis, groups more likely to report not having been offered a statin were: women (RR 1.22), black patients (RR 1.48), and the uninsured (RR 1.38).
"Although it is impossible to know whether these patients were, in fact, never offered statin therapy or if they were but did not recall the conversation, these patients are likely to be open to a new conversation about statin therapy with their physician," the researchers noted.
Other limitations included potential overestimation of statin use by enrolling only patients potentially eligible for a statin, lack of representation of patients without access to healthcare, and that study questions could be skipped in the survey.
Weintraub also pointed out that primary and secondary cardiovascular prevention populations were lumped together and noted that there was no information on other lipid-lowering medication use, such as ezetimibe (Zetia).
The Patient and Provider Assessment of Lipid Management (PALM) registry received funding from Sanofi and Regeneron Pharmaceuticals.
Bradley disclosed no relevant relationships with industry.
Some co-authors disclosed employment with Sanofi and Regeneron Pharmaceuticals; others disclosed financial relationships with those companies and others.
Journal of the American Heart Association
Source Reference: Bradley CK, et al "Patient-Reported Reasons for Declining or Discontinuing Statin Therapy: Insights From the PALM Registry" J Am Heart Assoc 2019;8:e011765. DOI: 10.1161/JAHA.118.011765.
Read the original article on Medpage Today: The Good News on Statin Hesitancy