David Mann|Mark Woodward|Paul Muntner|Louise Falzon|Ian M. Kronish
Predictors of Nonadherence to Statins: A Systematic Review and Meta-Analysis
Icahn School of Medicine at Mount Sinai|The George Institute for Global Health|University of Sydney|University of Alabama at Birmingham|Columbia University Irving Medical Center|Icahn School of Medicine at Mount Sinai
nonadherence statins limits benefits common drug class individual studies assessing predictors nonadherence produced inconsistent resultsto identify reliable predictors nonadherence statins systematic review metaanalysismultiple databases including medline embase psycinfo searched inception february 2009 identify studies evaluated predictors nonadherence statins studies selected using priori defined criteria study reviewed 2 authors abstracted data study characteristics outcomes relative risks pooled using inversevariance weighted randomeffects modeltwentytwo cohort studies met inclusion criteria age ushaped association adherence oldest 70 years youngest 50 years subjects lower adherence middleaged 5069 years subjects women patients lower incomes likely nonadherent men odds nonadherence 107 95 ci 104 111 higher incomes odds nonadherence 118 95 ci 110 128 respectively history cardiovascular disease predicted better adherence statins odds nonadherence 068 95 ci 066 078 similarly diagnosis hypertension diabetes associated better adherence although studies quantitative pooling increased testing lipid levels lower outofpocket costs appeared associated better adherence substantial i2 range 687963 heterogeneity studies across factorsseveral sociodemographic medical healthcare utilization characteristics associated statin nonadherence factors may useful guides targeting statin adherence interventions