APPROACHES TO STATIN THERAPY ADHERENCE IMPROVEMENT

Most cardiovascular diseases (CVD) are of atherosclerotic origin, and lipid disorders play significant role, setting up the cardiovascular continuum, together with other risk factors. It also known that decrease of low density lipoproteins cholesterol (CLDL) level leads to decreased occurrence of CVDs in primary and secondary prevention of the diseases. Statins, at the moment, are a standard of medical care. However, two problems remain on the way to cardiovascular risk reduction — insufficient statins prescription and low rate of archived target levels of cholesterol and CLDL. In the end of October 2017, by the initiative of Sandoz LLC, in Kazan an educational seminar was conducted, where the representatives from 12 regions discussed the issues on statin therapy adherence improvement. Seminar program included lectures, practical interactive events and general discussion. As a specifics of the seminar, the participants not only listened to lectures, but prepared proposals in interactive regimen, discussed them with the colleagues, presented and defended projects. So, every participant was merged into the problem and directly influenced the discussion. Among the participants were internists, cardiologists, neurologists. Seminar vector was directed to revealing and overcoming such barriers for statin adherence as the so­called barriers of consent, understanding and availability, that depend on clinician as well as patient and healthcare system. Also the issues were discussed on the Internet influence on “antistatin” behavior, that prefers “good” bioactive compounds for “vile” statins.

1. Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics — 2016 update: a report from the American Heart Association. Circulation 2016; 133: e38360. DOI: 10.1161/CIR.0000000000000350.

2. ROSSTAT. The demographic Yearbook of Russia. Official edition 2015. (In Russ.) РОССТАТ. Демографический ежегодник России. Официальное издание 2015. ISBN 978­5­89476­414­6.

3. Kannel WB, Dawber TR, Friedman GD, et al. Risk factors in coronary heart disease. An evaluation of several serum lipids as predictors of coronary heart disease; the Framingham study. Ann Intern Med 1964; 61: 888­99.

4. Cholesterol Treatment Trialists’ (CTT) Collaboration. Efficacy and safety of LDLlowering therapy among men and women: meta­analysis of individual data from 174,000 participants in 27 randomized trials. Lancet 2015; 385: 1397­405. DOI: 10.1016/S0140­6736(14)61368­4.

5. Ference BA, Ginsberg HN, Graham I, et al. Low­density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel. Eur Heart J 2017; 38 (32): 2459­72. DOI: 10.1093/eurheartj/ehx144.

6. Meshkov AN, Ershova AI, Deev AD, et al. Distribution of lipid profile values in economically active men and women in Russian federation: results of the ESSERF study for the years 2012­2014. Cardiovascular Therapy and Prevention 2017; 16 (4): 62­7. (In Russ.). DOI: 10.15829/1728­8800­2017­4­62­67.

7. Lebedeva AYu, Klykov LL, Zaitseva VV. CHD in young women: the problems of diagnosis and prevention. Russian Journal of Cardiology 2011; 6 (92): 90­7. (In Russ.)DOI: 10.15829/1560­4071­2011­6­110­114.

8. Shalnova SA, Deev AD, Metelskaja VA, et al. Awareness and treatment specifics of statin therapy in persons with various cardiovasular risk: the study ESSERF. Cardiovascular Therapy and Prevention 2016; 15 (4): 29­37. (In Russ.). DOI: 10.15829/1728­8800­2016­4­29­37.

9. Maningat P, Gordon BR, Breslow JL. How Do We Improve Patient Compliance and Adherence to Long­Term Statin Therapy? Cur atheroscler rep 2013; 15 (1): 291. DOI: 10.1007/s11883­012­0291­7.

10. Mann DM, Woodward M, Muntner P, et al. Predictors of nonadherence to statins: a systematic review and meta­analysis. Ann Pharmacother 2010; 44 (9): 1410­21. DOI: 10.1345/aph.1P150.

11. Ageev FТ, Averin YuP. What does a regular patient usually do with his prescribed 1­2 simvastatin tablets? Part 2. Results of a sociological survey among patients prescribed simvastatin, as a part of the Russian Federation Study Program. Serdtse 2008; 7 (5): 311­5. (In Russ.)

12. Oganov RG, Kukharchuk VV, Arutyunov GP, et al. Persistent dyslipidemia in statintreated patients: Russian real­world clinical practice data (Russian part of the DYSIS Study). Cardiovascular Therapy and Prevention 2012; 11 (4): 70­8. (In Russ.)

13. Reiner Ž, De Backer G, Fras Z, et al. Lipid lowering drug therapy in patients with coronary heart disease from 24 European countries. Findings from the EUROASPIRE IV survey. Atherosclerosis 2015; 246: 243­50. DOI: 10.1016/j.atherosclerosis.2016.01.018.

14. Nedogoda SV, Tsoma VV, Ledjaeva AA. Adherence to statinotherapy and possibility to improve it in real clinical practice. RMZh 2009; 17 (18): 1086­9. (In Russ.)

15. Smirnova MD, Ageev FT. Statins — the old myths and new facts. RMZh 2017; 20: 1421­8. (In Russ.) Смирнова М. Д., Агеев Ф. Т. Статины — старые мифы и новые факты. РМЖ 2017; 20: 1421­8.

16. Naghavi M, Wang H, Lozano R, et al. Global, regional, and national age–sex specific all­cause and cause­specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015; 385 (9963): 117­71. DOI: 10.1016/S0140­6736(14)61682­2.

17. Blackburn DF, Pharm D, Dobson R, et al. Cardiovascular Morbidity Associated with nonadherence to statin therapy. Pharmacotherapy 2005; 25 (8): 1035­43. DOI: 10.1592/phco.2005.25.8.1035.

18. Gomez Sandoval YH, Braganza MV, Daskalopoulou SS. Statin discontinuation in high­risk patients: a systematic review of the evidence. Curr Pharm Des 2011; 17 (33): 3669­89.

19. Simpson DT, Eurich SR, Majumdar RS, et al. A meta­analysis of the association between adherence to drug therapy and mortality. BMJ 2006; 333­45. DOI: 10.1136/bmj.38875.675486.55

20. Langsted A, Freiberg JJ, Nordestgaard BG. Extent of undertreatment and overtreatment with cholesterol­lowering therapy according to European guidelines in 92,348 Danes without ischemic cardiovascular disease and diabetes in 2004­2014. Atherosclerosis 2017; 257: 9­15. DOI: 10.1016/j.atherosclerosis.2016.11.025.

21. Newby LK, LaPointe NM, Chen AY, et al. Long­term adherence to evidence­based secondary prevention therapies in coronary artery disease. Circulation 2006; 113 (2): 203­12. DOI: 10.1161/CIRCULATIONAHA.105.505636.

22. Lamberts EJ, Nijpels G, Welschen LM, et al. Discontinuation of statins among patients with type 2 diabetes. Diabetes Metab Res Rev 2012; 28 (3): 241­5. DOI: 10.1002/dmrr.1293.

23. World Health Organisation. Adherence to Long­Term therapies: evidence for action. Geneva. http://www.who.int2 (2003).

24. Dombrovsky VS, Omelyanovsky VV. Study Questions of Treatment Compliance: Assessment Criteria and Terminology. Medical technologies: assessment and choice 2015; 2 (20): 16­23. (In Russ.) Домбровский В. С., Омельяновский В. В. Вопросы изучения приверженности лечению: критерии оценки и терминология. Медицинские технологии: оценка и выбор 2015; 2 (20): 16­23.

25. Alberico L Catapano, Ian Graham, Guy De Backer, et al. 2016 ESC/EAS Guidelines for the management of Dyslipidemias. The Task Force for the Management of Dyslipidemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS). Eur Heart J 2016; 37 (39): 2999­3058. DOI: 10.1093/eurheartj/ehr158.

26. Nissen SE. Statin Denialism Internet Cult with Deadly Consequences. Ann Intern Med 2017; 167 (4): 281­2. DOI: 10.7326/M17­1566.