Statin treatment after acute coronary syndrome: Adherence and reasons for non-adherence in a randomized controlled intervention trial

Abstract Studies of secondary prevention for cardiovascular disease show low fulfilment of guideline-recommended targets. This study explored whether nurse-led follow-up could increase adherence to statins over time and reasons for discontinuation. All patients admitted for acute coronary syndrome a...

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Autores principales:	Huber Daniel, Wikén Christian, Henriksson Robin, Söderström Lars, Mooe Thomas
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2019
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/c50387ba2f784b19a0d15739ff7db0fa
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spelling	oai:doaj.org-article:c50387ba2f784b19a0d15739ff7db0fa2021-12-02T16:08:16ZStatin treatment after acute coronary syndrome: Adherence and reasons for non-adherence in a randomized controlled intervention trial10.1038/s41598-019-48540-32045-2322https://doaj.org/article/c50387ba2f784b19a0d15739ff7db0fa2019-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-019-48540-3https://doaj.org/toc/2045-2322Abstract Studies of secondary prevention for cardiovascular disease show low fulfilment of guideline-recommended targets. This study explored whether nurse-led follow-up could increase adherence to statins over time and reasons for discontinuation. All patients admitted for acute coronary syndrome at Östersund hospital between 2010–2014 were screened for the randomized controlled NAILED-ACS trial. The trial comprises two groups, one with nurse-led annual follow-up and medical titration by telephone to reach set intervention targets and one with usual care. All discontinuations of statins were recorded prospectively for at least 36 months and categorized as avoidable or unavoidable. Kaplan-Meier estimates were conducted for first and permanent discontinuations. Predictors for discontinuation were analysed using multivariate Cox regression, statin type and mean LDL-C at end of follow-up. Female gender was a predictor for discontinuation. Allocation in the intervention group predicted increased risk for a first but decreased risk for permanent discontinuation. A nurse-led telemedical secondary prevention programme in a relatively unselected ACS cohort leads to increased adherence to statins over time, greater percentage on potent treatment and lower LDL-C compared to usual care. An initially increased tendency toward early discontinuation in the intervention group stresses the importance of a longer duration of structured follow-up.Huber DanielWikén ChristianHenriksson RobinSöderström LarsMooe ThomasNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 9, Iss 1, Pp 1-10 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Huber Daniel Wikén Christian Henriksson Robin Söderström Lars Mooe Thomas Statin treatment after acute coronary syndrome: Adherence and reasons for non-adherence in a randomized controlled intervention trial
description	Abstract Studies of secondary prevention for cardiovascular disease show low fulfilment of guideline-recommended targets. This study explored whether nurse-led follow-up could increase adherence to statins over time and reasons for discontinuation. All patients admitted for acute coronary syndrome at Östersund hospital between 2010–2014 were screened for the randomized controlled NAILED-ACS trial. The trial comprises two groups, one with nurse-led annual follow-up and medical titration by telephone to reach set intervention targets and one with usual care. All discontinuations of statins were recorded prospectively for at least 36 months and categorized as avoidable or unavoidable. Kaplan-Meier estimates were conducted for first and permanent discontinuations. Predictors for discontinuation were analysed using multivariate Cox regression, statin type and mean LDL-C at end of follow-up. Female gender was a predictor for discontinuation. Allocation in the intervention group predicted increased risk for a first but decreased risk for permanent discontinuation. A nurse-led telemedical secondary prevention programme in a relatively unselected ACS cohort leads to increased adherence to statins over time, greater percentage on potent treatment and lower LDL-C compared to usual care. An initially increased tendency toward early discontinuation in the intervention group stresses the importance of a longer duration of structured follow-up.
format	article
author	Huber Daniel Wikén Christian Henriksson Robin Söderström Lars Mooe Thomas
author_facet	Huber Daniel Wikén Christian Henriksson Robin Söderström Lars Mooe Thomas
author_sort	Huber Daniel
title	Statin treatment after acute coronary syndrome: Adherence and reasons for non-adherence in a randomized controlled intervention trial
title_short	Statin treatment after acute coronary syndrome: Adherence and reasons for non-adherence in a randomized controlled intervention trial
title_full	Statin treatment after acute coronary syndrome: Adherence and reasons for non-adherence in a randomized controlled intervention trial
title_fullStr	Statin treatment after acute coronary syndrome: Adherence and reasons for non-adherence in a randomized controlled intervention trial
title_full_unstemmed	Statin treatment after acute coronary syndrome: Adherence and reasons for non-adherence in a randomized controlled intervention trial
title_sort	statin treatment after acute coronary syndrome: adherence and reasons for non-adherence in a randomized controlled intervention trial
publisher	Nature Portfolio
publishDate	2019
url	https://doaj.org/article/c50387ba2f784b19a0d15739ff7db0fa
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Statin treatment after acute coronary syndrome: Adherence and reasons for non-adherence in a randomized controlled intervention trial

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