PMID- 16849622
OWN - NLM
STAT- MEDLINE
DCOM- 20070221
LR  - 20151119
IS  - 1060-0280 (Print)
IS  - 1060-0280 (Linking)
VI  - 40
IP  - 7-8
DP  - 2006 Jul-Aug
TI  - Adherence and persistence with single-dosage form extended-release 
      niacin/lovastatin compared with statins alone or in combination with 
      extended-release niacin.
PG  - 1274-9
AB  - BACKGROUND: Lipid-lowering therapies have been shown to reduce cardiovascular 
      events and mortality; patient cooperation with therapy varies. A fixed-dose 
      combination product, extended-release niacin/lovastatin (ERNL), has been shown to 
      be beneficial in lipid management; however, little is known regarding patient 
      behavior with ERNL therapy. OBJECTIVE: To evaluate patient adherence and 
      persistence with ERNL, statin monotherapy (SM), extended-release niacin (ERN) 
      monotherapy, and ERN plus a statin (ERN-S). METHODS: Prescription claims for 
      lipid-lowering therapies were obtained from a pharmacy benefits manager between 
      2002 and 2003. Claims for a total of 2389 patients were analyzed for adherence 
      and persistence, using medication possession ratios (MPRs) and proportions of 
      days covered (PDCs). Adherence and persistence were defined, respectively, as an 
      MPR or PDC greater than or equal to 0.80. Logistic regression was conducted to 
      detect differences among groups. Covariates included age, gender, copay, and 
      number of lipid-lowering therapies, a surrogate for disease severity. RESULTS: 
      Average MPR scores were relatively high in all groups at 0.88, 0.81, 0.89, and 
      0.90 for ERNL, SM, ERN, and ERN-S, respectively. The adjusted odds ratio for 
      adherence was lowest for SM (0.69), which was statistically significant compared 
      with ERN-S (1.43), but not ERNL (1.00) or ERN (0.74). Persistence outcomes were 
      poor in all groups. By the fourth quarter, patients receiving ERN-S (OR 1.31) had 
      significantly greater persistence than those receiving ERN (OR 0.41) and SM 
      (0.61), but not those receiving ERNL (OR 1.00). CONCLUSIONS: Managed care 
      patients tended to be adherent to chronic lipid-lowering therapies, based on a 
      mean MPR greater than 0.8. However, most patients failed to persist for at least 
      6 months.
FAU - LaFleur, Joanne
AU  - LaFleur J
AD  - Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake 
      City, 84108, USA. joanne.lafleur@pharm.utah.edu
FAU - Thompson, Clinton J
AU  - Thompson CJ
FAU - Joish, Vijay N
AU  - Joish VN
FAU - Charland, Scott L
AU  - Charland SL
FAU - Oderda, Gary M
AU  - Oderda GM
FAU - Brixner, Diana I
AU  - Brixner DI
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20060718
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
RN  - 0 (Delayed-Action Preparations)
RN  - 0 (Drug Combinations)
RN  - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
RN  - 0 (Hypolipidemic Agents)
RN  - 2679MF687A (Niacin)
RN  - 9LHU78OQFD (Lovastatin)
SB  - IM
MH  - Delayed-Action Preparations
MH  - Drug Combinations
MH  - Female
MH  - Humans
MH  - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*administration & dosage
MH  - Hypolipidemic Agents/*administration & dosage
MH  - Lovastatin/administration & dosage
MH  - Male
MH  - Middle Aged
MH  - Niacin/administration & dosage
MH  - Patient Compliance/*statistics & numerical data
EDAT- 2006/07/20 09:00
MHDA- 2007/02/22 09:00
CRDT- 2006/07/20 09:00
PHST- 2006/07/20 09:00 [pubmed]
PHST- 2007/02/22 09:00 [medline]
PHST- 2006/07/20 09:00 [entrez]
AID - aph.1G646 [pii]
AID - 10.1345/aph.1G646 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2006 Jul-Aug;40(7-8):1274-9. doi: 10.1345/aph.1G646. Epub 2006 
      Jul 18.