1995 年至 2004 年间 10 个新用户队列中他汀类药物使用模式：基于登记的全国性研究。
Pattern of statin use among 10 cohorts of new users from 1995 to 2004: a register-based nationwide study.
机构信息
Department of Pharmacology, Drug Development, and Therapeutics, University of Turku, FI-20014 Turku, Finland.
出版信息
Am J Manag Care. 2010 Feb;16(2):116-22.
OBJECTIVE
To analyze differences in the pattern of statin use among 10 consecutive yearly cohorts of new users in Finland.
STUDY DESIGN
Retrospective cohort study based on administrative claims data.
METHODS
New users of statins from January 1, 1995, to December 31, 2004, were captured from a nationwide prescription register, and the pattern of statin use was observed until December 31, 2005. The association between year of statin initiation and persistence with statin therapy during the first year of statin use was modeled using Cox proportional hazards regression analysis with multivariable adjustment. The median adherence (proportion of days covered) was computed among patients who discontinued therapy during each 365-day interval since statin initiation.
RESULTS
In total, 490,024 new users of statins were identified. In the multivariable-adjusted model, discontinuation during the first year among initiators of statin use in 1996 and 1997 was similar to that in 1995 (hazard ratio [HR], 0.99; 95% confidence interval [CI], 0.95-1.03 in 1996; and HR, 1.01; 95% CI, 0.98-1.05 in 1997). Compared with the 1995 cohort, the 1998, 1999, 2000, 2001, 2002, 2003, and 2004 cohorts were less likely to discontinue statin use. Hazard ratios of discontinuation for the cohorts ranged from 0.91 (95% CI, 0.88-0.94) in 1998 to 0.80 (95% CI, 0.78-0.83) in 2004. There were no differences in adherence with respect to the duration of therapy among the yearly cohorts.
CONCLUSIONS
Compared with the 1995 cohort, 1-year persistence with statin therapy in Finland improved among new users of statins in 1998, and the improvement persisted up to 2004. Adherence to statin therapy remained stable among initiators from 1995 to 2004.
目的
分析芬兰连续 10 年新使用者中他汀类药物使用模式的差异。
研究设计
基于行政索赔数据的回顾性队列研究。
方法
1995 年 1 月 1 日至 2004 年 12 月 31 日，从全国处方登记处捕获新使用他汀类药物的患者，并观察到 2005 年 12 月 31 日为止的他汀类药物使用模式。使用多变量调整的 Cox 比例风险回归分析模型，对他汀类药物起始年份与他汀类药物治疗第一年的持续性之间的关联进行建模。在每个 365 天的间隔内，计算停止治疗的患者的中位数（覆盖天数的比例）。
结果
共确定了 490,024 名新使用他汀类药物的患者。在多变量调整模型中，1996 年和 1997 年开始使用他汀类药物的患者在第一年的停药率与 1995 年相似（风险比[HR]，0.99；95%置信区间[CI]，0.95-1.03 在 1996 年；和 HR，1.01；95% CI，0.98-1.05 在 1997 年）。与 1995 年队列相比，1998 年、1999 年、2000 年、2001 年、2002 年、2003 年和 2004 年队列不太可能停止使用他汀类药物。停药的风险比范围为 1998 年的 0.91（95% CI，0.88-0.94）至 2004 年的 0.80（95% CI，0.78-0.83）。在每年的队列中，治疗持续时间的依从性没有差异。
结论
与 1995 年队列相比，1998 年芬兰新使用他汀类药物的患者 1 年内坚持他汀类药物治疗的情况有所改善，并且这种改善一直持续到 2004 年。1995 年至 2004 年，起始者对他汀类药物治疗的依从性保持稳定。
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