Preventive cardiologyIntervention to Improve Adherence to Lipid-Lowering Medication and Lipid-Levels in Patients With an Increased Cardiovascular Risk
Section snippets
Methods
Patients (aged >18 years) with indications for statin use (primary or secondary prevention of cardiovascular events) were consecutively selected from the outpatient clinics of 2 hospitals in Amsterdam, The Netherlands (Academic Medical Center and the Slotervaart Hospital) by their treating physicians and included from May 2002 to May 2004. Patients with severe fasting dyslipidemia (total cholesterol >9.0 mmol/L or triglycerides >4.0 mmol/L) were excluded, as were those with fasting glucose >7.0
Results
A total of 201 consecutive patients were enrolled (Figure 2). Characteristics at baseline are listed in Table 1. There were no statistically significant differences in baseline characteristics between patients in the 2 study arms within the subgroups of primary and secondary prevention patients.
LDL cholesterol was statistically significantly lower in the EC group than in the RC group during follow-up in primary prevention patients but not in secondary prevention patients (Table 2, Figure 3).
Discussion
In this randomized controlled trial, nurse-led multifactorial cardiovascular risk-factor counseling resulted in higher levels of adherence to lipid-lowering medication and lower LDL cholesterol concentrations in primary prevention patients, without increasing patients' anxiety compared to RC. LDL cholesterol reductions were significantly related to improved adherence to statins, also when adjusted for the dose and type of the statin. High-density lipoprotein cholesterol, triglycerides, IMT, and
References (25)
- et al.
Cost-effectiveness of screening for albuminuria with subsequent fosinopril treatment to prevent cardiovascular events: a pharmacoeconomic analysis linked to the prevention of renal and vascular endstage disease (PREVEND) study and the prevention of renal and vascular endstage disease intervention trial (PREVEND IT)
Clin Ther
(2006) - et al.
Variability of flow mediated dilation: consequences for clinical application
Atherosclerosis
(2001) - et al.
Patients' beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness
J Psychosom Res
(1999) - et al.
Perceived control reduces emotional stress in patients with heart failure
J Heart Lung Transplant
(2003) - et al.
Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes
N Engl J Med
(2003) - et al.
The effect of giving global coronary risk information to adults: a systematic review
Arch Intern Med
(2010) - et al.
Prediction of coronary heart disease using risk factor categories
Circulation
(1998) - et al.
Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge
Clin Chem
(1972) - et al.
Self-reported adherence is more predictive of virologic treatment response among patients with a lower tendency towards socially desirable responding
Antivir Ther
(2010) - et al.
Limited patient adherence to highly active antiretroviral therapy for HIV-1 infection in an observational cohort study
Arch Intern Med
(2001)
The hospital anxiety and depression scale
Acta Psychiatr Scand
A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity
Med Care
Cited by (53)
Effects of a lifestyle-related risk factor modification intervention on lifestyle changes among patients with coronary artery disease in Nepal
2021, Patient Education and CounselingAn Educational Intervention to Improve Statin Use: Cluster RCT at the Primary Care Level in Argentina
2019, American Journal of Preventive MedicineExploring the Barriers to and Facilitators of Using Evidence-Based Drugs in the Secondary Prevention of Cardiovascular Diseases: Findings From a Multistakeholder, Qualitative Analysis
2018, Global HeartCitation Excerpt :Conversely, physicians in India stated that NPHW lack the clinical expertise to manage cardiovascular medications. Several studies have demonstrated improved adherence [30], health outcomes [31], treatment concordance between physicians and NPHW, and the cost-effectiveness of task shifting for chronic disease management [32,33]. Furthermore, Adeyemo et al. [34] showed that nurse-led follow-up, counseling, and medication prescription resulted in high rates of adherence in Nigerian hypertensive patients, suggesting that it is a suitable intervention in middle- and low-income countries.
This study was funded in part by Pfizer (Capelle aan den IJssel, The Netherlands).