– [May 13, 2013] – High cholesterol is one of the major risk factors for coronary heart disease
, heart attack and stroke
, which can be well managed with available prescription medications. New research sheds light onto the impact of gender and race on medication adherence for statins used to treat high cholesterol. The study, conducted by researchers at CVS Caremark and Brigham and Women’s Hospital and published in the May issue of The American Heart Journal
, found that non-white patients had 50 percent greater odds of statin medication non-adherence compared to white patients, while women had 10 percent greater odds of statin non-adherence compared to men.
“These findings help us better understand the impact of certain demographic factors on medication adherence,” said Niteesh Choudhry, MD, PhD, associate physician, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital and associate professor, Harvard Medical School. “Since a large number of patients depend on medication therapy for primary and secondary prevention of cardiovascular disease, we believe that efforts to reduce non-adherence for statins can have a significant effect on addressing health care disparities, improving health outcomes and ultimately reducing costs.”
The study consisted of a literature review of more than 50 publications focused on gender and racial disparities associated with medication adherence and included more than 1.7 million patients. Of note, the finding that non-adherence was higher based on the patient’s gender or race held true even in those studies that adjusted for income, insurance status, co-payment amounts and other clinically important factors that could contribute to non-adherence.
“While it has long been known that sociodemographic characteristics are associated with non-adherence, this study is the first of its kind to look at the scale and scope of this association,” said Troy Brennan, MD, MPH, Executive Vice President and Chief Medical Officer of CVS Caremark. “This research helps those of us in the health care field better understand how to improve our outreach to patients who may be at a higher risk of non-adherence and develop programs to help these patients improve their medication adherence.”
The researchers note that there are a number of potential reasons for non-adherence among women and non-white patients. For example, active prevention of cardiovascular disease may not be a priority for women and their health care providers because of the common misconception that women are less at risk than men. In addition, women also frequently serve as informal caregivers for family members and may be further impacted by the fact that caregivers frequently have lower rates of medication adherence. The reasons that non-white patients may be non-adherent are more complex. As an example, the researchers note that non-white patients are less likely to have a consistent relationship with a primary care provider than white patients which can impact chronic care and adherence. Additionally, both women and various racial and ethnic minorities may be more likely to experience side effects from statins, a commonly cited reason for early discontinuation or poor adherence.
CVS Caremark has been working in a multi-year collaboration with Brigham and Women's Hospital to research pharmacy claims data in order to better understand patient behavior, particularly around medication adherence. Annual excess health care costs due to medication non-adherence in the U.S. have been estimated to be as much as $290 billion annually.