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A simple informative intervention in primary care increases statin adherence
Purpose To assess the effectiveness of an informative intervention on general practitioners aimed at improving patients’ adherence to statin therapy. Methods In the local health unit (LHU) of Bergamo, Lombardy (Italy), each general practitioner received a synthetic scientific document on dyslipidaem...
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| Published in: | European journal of clinical pharmacology 2016-02, Vol.72 (2), p.227-234 |
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| Main Authors: | , , , , , , , , , |
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| container_issue | 2 |
| container_start_page | 227 |
| container_title | European journal of clinical pharmacology |
| container_volume | 72 |
| creator | Casula, Manuela Tragni, Elena Piccinelli, Rossana Zambon, Antonella De Fendi, Luisa Scotti, Lorenza Corrao, Giovanni Gambera, Marco Catapano, Alberico Luigi Filippi, Alessandro |
| description | Purpose
To assess the effectiveness of an informative intervention on general practitioners aimed at improving patients’ adherence to statin therapy.
Methods
In the local health unit (LHU) of Bergamo, Lombardy (Italy), each general practitioner received a synthetic scientific document on dyslipidaemia and statins and aggregated data on adherence in 2006 for his/her patients compared to the means in the LHU and in his/her working district. Furthermore, a sample of seven districts received also a table of adherence levels for single patients. Patient’s level data were retrieved from the health care utilisation databases of the LHU. Adherence parameters (proportion of patients with only one prescription, medication possession ratio [MPR] and proportion of non-persistent patients) were assessed after 1 year of follow-up.
Results
Overall, 5833 and 4788 new statin users were enrolled before and after the intervention, respectively. The percentage of patients with only one prescription decreased from 28.0 to 23.9 % (
p
|
| doi_str_mv | 10.1007/s00228-015-1975-z |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1760928542</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1760928542</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-7a12704e3094fcb011444a74db5210c1c9aadbcf7138a24e4042b93df5378583</originalsourceid><addsrcrecordid>eNp1kE1LAzEQhoMotlZ_gBdZ8OJldSYfm91jKX5BwUvvIZud1S3d3ZpsC_rrTWkVETxlwjzzJvMwdolwiwD6LgBwnqeAKsVCq_TziI1RCp4iSDxmYwCBaVZoGLGzEJYQwQLEKRvxTGUC83zM5tMkNO16RUnT1b1v7dBsd_VAfkvd0PRdvCRr37TWfyTO-l3TebKBQhKGiHeJrd7IU-fonJ3UdhXo4nBO2OLhfjF7Sucvj8-z6Tx1QvMh1Ra5BkkCClm7EhCllFbLqlQcwaErrK1KV2sUueWSJEheFqKqldC5ysWE3exj175_31AYTNsER6uV7ajfBIM6g4LnSvKIXv9Bl_3Gd_FzkVJZtAGqiBTuKef7EDzV5rCwQTA702Zv2kSBZmfafMaZq0Pypmyp-pn4VhsBvgdCbHWv5H89_W_qFzXCiJc</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1756903059</pqid></control><display><type>article</type><title>A simple informative intervention in primary care increases statin adherence</title><source>Springer Nature</source><creator>Casula, Manuela ; Tragni, Elena ; Piccinelli, Rossana ; Zambon, Antonella ; De Fendi, Luisa ; Scotti, Lorenza ; Corrao, Giovanni ; Gambera, Marco ; Catapano, Alberico Luigi ; Filippi, Alessandro</creator><creatorcontrib>Casula, Manuela ; Tragni, Elena ; Piccinelli, Rossana ; Zambon, Antonella ; De Fendi, Luisa ; Scotti, Lorenza ; Corrao, Giovanni ; Gambera, Marco ; Catapano, Alberico Luigi ; Filippi, Alessandro</creatorcontrib><description>Purpose
To assess the effectiveness of an informative intervention on general practitioners aimed at improving patients’ adherence to statin therapy.
Methods
In the local health unit (LHU) of Bergamo, Lombardy (Italy), each general practitioner received a synthetic scientific document on dyslipidaemia and statins and aggregated data on adherence in 2006 for his/her patients compared to the means in the LHU and in his/her working district. Furthermore, a sample of seven districts received also a table of adherence levels for single patients. Patient’s level data were retrieved from the health care utilisation databases of the LHU. Adherence parameters (proportion of patients with only one prescription, medication possession ratio [MPR] and proportion of non-persistent patients) were assessed after 1 year of follow-up.
Results
Overall, 5833 and 4788 new statin users were enrolled before and after the intervention, respectively. The percentage of patients with only one prescription decreased from 28.0 to 23.9 % (
p
< 0.001). MPR increased from 70.3 to 76.0 % (
p
< 0.001), and proportion of patients with MPR ≥80 % increased from 45.4 to 56.4 % (
p
< 0.001). The persistence also showed an improvement, both in terms of decreasing proportion of non-persistent (from 51.9 to 41.4 %,
p
< 0.001) and of increasing duration of continued therapy (from 235 to 264 mean days of persistent therapy,
p
< 0.001). There were not significant differences between the two types of intervention.
Conclusions
This intervention resulted in an overall improvement of the short-term adherence to therapy. This tool can be replicated in other local contexts and with other chronic therapies.</description><identifier>ISSN: 0031-6970</identifier><identifier>EISSN: 1432-1041</identifier><identifier>DOI: 10.1007/s00228-015-1975-z</identifier><identifier>PMID: 26563188</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biomedical and Life Sciences ; Biomedicine ; Chronic illnesses ; Drug therapy ; Dyslipidemias - drug therapy ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use ; Male ; Medication Adherence - statistics & numerical data ; Middle Aged ; Patient Education as Topic ; Pharmacoepidemiology and Prescription ; Pharmacology/Toxicology ; Primary care ; Primary Health Care ; Statins</subject><ispartof>European journal of clinical pharmacology, 2016-02, Vol.72 (2), p.227-234</ispartof><rights>Springer-Verlag Berlin Heidelberg 2015</rights><rights>Springer-Verlag Berlin Heidelberg 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-7a12704e3094fcb011444a74db5210c1c9aadbcf7138a24e4042b93df5378583</citedby><cites>FETCH-LOGICAL-c372t-7a12704e3094fcb011444a74db5210c1c9aadbcf7138a24e4042b93df5378583</cites><orcidid>0000-0002-5124-5361</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26563188$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Casula, Manuela</creatorcontrib><creatorcontrib>Tragni, Elena</creatorcontrib><creatorcontrib>Piccinelli, Rossana</creatorcontrib><creatorcontrib>Zambon, Antonella</creatorcontrib><creatorcontrib>De Fendi, Luisa</creatorcontrib><creatorcontrib>Scotti, Lorenza</creatorcontrib><creatorcontrib>Corrao, Giovanni</creatorcontrib><creatorcontrib>Gambera, Marco</creatorcontrib><creatorcontrib>Catapano, Alberico Luigi</creatorcontrib><creatorcontrib>Filippi, Alessandro</creatorcontrib><title>A simple informative intervention in primary care increases statin adherence</title><title>European journal of clinical pharmacology</title><addtitle>Eur J Clin Pharmacol</addtitle><addtitle>Eur J Clin Pharmacol</addtitle><description>Purpose
To assess the effectiveness of an informative intervention on general practitioners aimed at improving patients’ adherence to statin therapy.
Methods
In the local health unit (LHU) of Bergamo, Lombardy (Italy), each general practitioner received a synthetic scientific document on dyslipidaemia and statins and aggregated data on adherence in 2006 for his/her patients compared to the means in the LHU and in his/her working district. Furthermore, a sample of seven districts received also a table of adherence levels for single patients. Patient’s level data were retrieved from the health care utilisation databases of the LHU. Adherence parameters (proportion of patients with only one prescription, medication possession ratio [MPR] and proportion of non-persistent patients) were assessed after 1 year of follow-up.
Results
Overall, 5833 and 4788 new statin users were enrolled before and after the intervention, respectively. The percentage of patients with only one prescription decreased from 28.0 to 23.9 % (
p
< 0.001). MPR increased from 70.3 to 76.0 % (
p
< 0.001), and proportion of patients with MPR ≥80 % increased from 45.4 to 56.4 % (
p
< 0.001). The persistence also showed an improvement, both in terms of decreasing proportion of non-persistent (from 51.9 to 41.4 %,
p
< 0.001) and of increasing duration of continued therapy (from 235 to 264 mean days of persistent therapy,
p
< 0.001). There were not significant differences between the two types of intervention.
Conclusions
This intervention resulted in an overall improvement of the short-term adherence to therapy. This tool can be replicated in other local contexts and with other chronic therapies.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Chronic illnesses</subject><subject>Drug therapy</subject><subject>Dyslipidemias - drug therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use</subject><subject>Male</subject><subject>Medication Adherence - statistics & numerical data</subject><subject>Middle Aged</subject><subject>Patient Education as Topic</subject><subject>Pharmacoepidemiology and Prescription</subject><subject>Pharmacology/Toxicology</subject><subject>Primary care</subject><subject>Primary Health Care</subject><subject>Statins</subject><issn>0031-6970</issn><issn>1432-1041</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNp1kE1LAzEQhoMotlZ_gBdZ8OJldSYfm91jKX5BwUvvIZud1S3d3ZpsC_rrTWkVETxlwjzzJvMwdolwiwD6LgBwnqeAKsVCq_TziI1RCp4iSDxmYwCBaVZoGLGzEJYQwQLEKRvxTGUC83zM5tMkNO16RUnT1b1v7dBsd_VAfkvd0PRdvCRr37TWfyTO-l3TebKBQhKGiHeJrd7IU-fonJ3UdhXo4nBO2OLhfjF7Sucvj8-z6Tx1QvMh1Ra5BkkCClm7EhCllFbLqlQcwaErrK1KV2sUueWSJEheFqKqldC5ysWE3exj175_31AYTNsER6uV7ajfBIM6g4LnSvKIXv9Bl_3Gd_FzkVJZtAGqiBTuKef7EDzV5rCwQTA702Zv2kSBZmfafMaZq0Pypmyp-pn4VhsBvgdCbHWv5H89_W_qFzXCiJc</recordid><startdate>20160201</startdate><enddate>20160201</enddate><creator>Casula, Manuela</creator><creator>Tragni, Elena</creator><creator>Piccinelli, Rossana</creator><creator>Zambon, Antonella</creator><creator>De Fendi, Luisa</creator><creator>Scotti, Lorenza</creator><creator>Corrao, Giovanni</creator><creator>Gambera, Marco</creator><creator>Catapano, Alberico Luigi</creator><creator>Filippi, Alessandro</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5124-5361</orcidid></search><sort><creationdate>20160201</creationdate><title>A simple informative intervention in primary care increases statin adherence</title><author>Casula, Manuela ; Tragni, Elena ; Piccinelli, Rossana ; Zambon, Antonella ; De Fendi, Luisa ; Scotti, Lorenza ; Corrao, Giovanni ; Gambera, Marco ; Catapano, Alberico Luigi ; Filippi, Alessandro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-7a12704e3094fcb011444a74db5210c1c9aadbcf7138a24e4042b93df5378583</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Chronic illnesses</topic><topic>Drug therapy</topic><topic>Dyslipidemias - drug therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use</topic><topic>Male</topic><topic>Medication Adherence - statistics & numerical data</topic><topic>Middle Aged</topic><topic>Patient Education as Topic</topic><topic>Pharmacoepidemiology and Prescription</topic><topic>Pharmacology/Toxicology</topic><topic>Primary care</topic><topic>Primary Health Care</topic><topic>Statins</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Casula, Manuela</creatorcontrib><creatorcontrib>Tragni, Elena</creatorcontrib><creatorcontrib>Piccinelli, Rossana</creatorcontrib><creatorcontrib>Zambon, Antonella</creatorcontrib><creatorcontrib>De Fendi, Luisa</creatorcontrib><creatorcontrib>Scotti, Lorenza</creatorcontrib><creatorcontrib>Corrao, Giovanni</creatorcontrib><creatorcontrib>Gambera, Marco</creatorcontrib><creatorcontrib>Catapano, Alberico Luigi</creatorcontrib><creatorcontrib>Filippi, Alessandro</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of clinical pharmacology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Casula, Manuela</au><au>Tragni, Elena</au><au>Piccinelli, Rossana</au><au>Zambon, Antonella</au><au>De Fendi, Luisa</au><au>Scotti, Lorenza</au><au>Corrao, Giovanni</au><au>Gambera, Marco</au><au>Catapano, Alberico Luigi</au><au>Filippi, Alessandro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A simple informative intervention in primary care increases statin adherence</atitle><jtitle>European journal of clinical pharmacology</jtitle><stitle>Eur J Clin Pharmacol</stitle><addtitle>Eur J Clin Pharmacol</addtitle><date>2016-02-01</date><risdate>2016</risdate><volume>72</volume><issue>2</issue><spage>227</spage><epage>234</epage><pages>227-234</pages><issn>0031-6970</issn><eissn>1432-1041</eissn><abstract>Purpose
To assess the effectiveness of an informative intervention on general practitioners aimed at improving patients’ adherence to statin therapy.
Methods
In the local health unit (LHU) of Bergamo, Lombardy (Italy), each general practitioner received a synthetic scientific document on dyslipidaemia and statins and aggregated data on adherence in 2006 for his/her patients compared to the means in the LHU and in his/her working district. Furthermore, a sample of seven districts received also a table of adherence levels for single patients. Patient’s level data were retrieved from the health care utilisation databases of the LHU. Adherence parameters (proportion of patients with only one prescription, medication possession ratio [MPR] and proportion of non-persistent patients) were assessed after 1 year of follow-up.
Results
Overall, 5833 and 4788 new statin users were enrolled before and after the intervention, respectively. The percentage of patients with only one prescription decreased from 28.0 to 23.9 % (
p
< 0.001). MPR increased from 70.3 to 76.0 % (
p
< 0.001), and proportion of patients with MPR ≥80 % increased from 45.4 to 56.4 % (
p
< 0.001). The persistence also showed an improvement, both in terms of decreasing proportion of non-persistent (from 51.9 to 41.4 %,
p
< 0.001) and of increasing duration of continued therapy (from 235 to 264 mean days of persistent therapy,
p
< 0.001). There were not significant differences between the two types of intervention.
Conclusions
This intervention resulted in an overall improvement of the short-term adherence to therapy. This tool can be replicated in other local contexts and with other chronic therapies.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>26563188</pmid><doi>10.1007/s00228-015-1975-z</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-5124-5361</orcidid></addata></record> |
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| ispartof | European journal of clinical pharmacology, 2016-02, Vol.72 (2), p.227-234 |
| issn | 0031-6970 1432-1041 |
| language | eng |
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| source | Springer Nature |
| subjects | Adult Aged Aged, 80 and over Biomedical and Life Sciences Biomedicine Chronic illnesses Drug therapy Dyslipidemias - drug therapy Female Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use Male Medication Adherence - statistics & numerical data Middle Aged Patient Education as Topic Pharmacoepidemiology and Prescription Pharmacology/Toxicology Primary care Primary Health Care Statins |
| title | A simple informative intervention in primary care increases statin adherence |
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