Poluzzi Elisabetta, Strahinja Petar, Lanzoni Monica, Vargiu Antonio, Silvani Maria Chiara, Motola Domenico, Gaddi Antonio, Vaccheri Alberto, Montanaro Nicola
Department of Pharmacology, University of Bologna, and Ahterosclerosis and Metabolic Diseases Study Centre, G. Descovich, Department of Clinical Medicine and Applied Biotechnology D. Campanacci, S. Orsola-Malpighi University Hospital, Bologna, Italy.
Eur J Clin Pharmacol. 2008 Apr;64(4):425-32. doi: 10.1007/s00228-007-0428-8. Epub 2008 Jan 5.
To evaluate the pattern of use of statins in the Emilia Romagna Region, with a focus on the therapeutic regimens and the patient's risk profile as predictors of adherence to therapy.
All patients from Emilia Romagna (4,027,275 inhabitants) receiving statin prescriptions in January-February 2005 were selected and observed for 12 months in terms of their statin regimen and use of other drugs for cardiovascular risk prevention. Previous hospital admissions for major cardiovascular events were also obtained. Adherence to statins was evaluated in terms of coverage (covered: >or=300 tablets/year). The relationship between coverage and risk profile (age, sex, other cardiovascular drugs, previous cardiovascular events and choice of drugs/dosages) was analysed by multivariate logistic regression.
Among the 137,217 patients receiving at least one prescription in the observation period, the rate of coverage was 46%. Coverage was statistically higher in patients with a previous hospital admission (secondary prevention) [Odds ratio (OR) 1.19; 95% confidence interval (95% CI) 1.16, 1.22], in those concomitantly treated with three to four different cardiovascular drugs (OR 2.77; 95% CI 2.66, 2.89). The coverage was also statistically higher in patients aged 50-69 years (OR 1.14; 95% CI 1.08, 1.20) and among males (OR 1.21; 95% CI 1.18, 1.23).
Less than half of patients receiving statin therapy took their medication daily, with a coverage only slightly higher in patients at higher cardiovascular risk. Three-quarters of the patients received statin therapy in primary prevention, whereas the benefits of statins are documented mostly for patients in secondary prevention. These findings strengthen the need to sensitise physicians and patients to the correct use of statins.
评估艾米利亚-罗马涅地区他汀类药物的使用模式，重点关注治疗方案以及作为治疗依从性预测指标的患者风险状况。
选取2005年1月至2月在艾米利亚-罗马涅地区（4,027,275名居民）接受他汀类药物处方的所有患者，并就其他汀类药物治疗方案以及用于心血管疾病风险预防的其他药物的使用情况进行为期12个月的观察。还获取了此前因重大心血管事件的住院记录。根据药物覆盖情况（覆盖：≥300片/年）评估他汀类药物的依从性。通过多因素逻辑回归分析覆盖情况与风险状况（年龄、性别、其他心血管药物、既往心血管事件以及药物/剂量选择）之间的关系。
在观察期内接受至少一张处方的137,217名患者中，药物覆盖率为46%。既往有住院记录（二级预防）的患者的覆盖率在统计学上更高[比值比（OR）1.19；95%置信区间（95%CI）1.16, 1.22]，同时接受三至四种不同心血管药物治疗的患者也是如此（OR 2.77；95%CI 2.66, 2.89）。50至69岁患者的覆盖率在统计学上也更高（OR 1.14；95%CI 1.08, 1.20），男性患者亦是如此（OR 1.21；95%CI 1.18, 1.23）。
接受他汀类药物治疗的患者中，不到一半的患者每日服药，心血管疾病风险较高的患者的药物覆盖率仅略高。四分之三的患者接受他汀类药物进行一级预防，而他汀类药物的益处大多记录在二级预防的患者中。这些发现强化了提高医生和患者对他汀类药物正确使用的认识的必要性。
