Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
J Clin Lipidol. 2021 Jan-Feb;15(1):181-191. doi: 10.1016/j.jacl.2020.11.001. Epub 2020 Nov 11.
Statin persistence and adherence are low among US adults. Most individuals with HIV in the US have high adherence to antiretroviral therapy (ART), but less is known about their statin persistence and adherence.
We analyzed persistence and adherence to statin therapy among adults with and without HIV.
We analyzed claims data from adults in the MarketScan database who initiated statin therapy between 2007 and 2016. People with HIV (n = 5619) were frequency matched 1-to-4 to those without HIV (n = 22,476) based on age, sex, and calendar year of statin initiation. Statin persistence was defined by having dispensed statin medication during the last 90 days of the 365 days following initiation. High statin adherence was defined as a proportion of days covered (PDC) ≥0.80 during the 365 days following initiation. Among people with HIV, the PDC for each ART was calculated.
The mean age of the study population was 51 years and 85.8% were men. Statin persistence was higher among adults with versus without HIV (72.8% versus 65.2%, multivariable-adjusted prevalence ratio 1.13, 95%CI 1.11-1.15). Among those who were persistent, a higher proportion of people with versus without HIV had high statin adherence (69.6% versus 59.9%, multivariable-adjusted prevalence ratio 1.16, 95%CI 1.13-1.19). Among people with HIV and high ART adherence (minimum PDC ≥0.90), 34.6% had a PDC for statin therapy <0.80.
Adults with HIV were more persistent and adherent to statin medications versus those without HIV. However, a high proportion of adults with HIV had low statin adherence.
美国成年人中他汀类药物的持久性和依从性较低。大多数美国的 HIV 感染者对抗逆转录病毒疗法 (ART) 的依从性很高，但对于他们的他汀类药物持久性和依从性了解较少。
我们分析了有和没有 HIV 的成年人使用他汀类药物的持久性和依从性。
我们分析了 2007 年至 2016 年期间在 MarketScan 数据库中开始使用他汀类药物的成年人的理赔数据。根据年龄、性别和他汀类药物起始的年份，将 5619 名 HIV 感染者（n=5619）与 22476 名无 HIV 感染者（n=22476）按 1:4 的频率进行匹配。他汀类药物的持久性定义为在起始后的 365 天内，最后 90 天内有配给他汀类药物。高他汀类药物依从性定义为起始后 365 天内的比例覆盖天数（PDC）≥0.80。在 HIV 感染者中，计算了每种 ART 的 PDC。
研究人群的平均年龄为 51 岁，85.8%为男性。与无 HIV 感染者相比，有 HIV 感染者的他汀类药物持久性更高（72.8%比 65.2%，多变量调整后的流行率比 1.13，95%CI 1.11-1.15）。在那些持续使用他汀类药物的患者中，与无 HIV 感染者相比，有更高比例的人具有高他汀类药物依从性（69.6%比 59.9%，多变量调整后的流行率比 1.16，95%CI 1.13-1.19）。在高 ART 依从性（最小 PDC≥0.90）的 HIV 感染者中，有 34.6%的人他汀类药物治疗的 PDC<0.80。
与无 HIV 感染者相比，HIV 感染者使用他汀类药物的持久性和依从性更高。然而，仍有相当比例的 HIV 感染者他汀类药物的依从性较低。
