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Member Research and Reports

Member Research and Reports

Brown: Patterns and Predictors of Medication Adherence to Lipid-lowering Therapy in Children Aged 8 to 20 Years

The American Academy of Pediatrics recommends lipid-lowering therapy for children at high risk for cardiovascular disease, however the use of lipid-lowering therapy in children is rare and adherence rates to such treatment are unknown.

Photo by Scott Kingsley
[Photo: Dr. Nina R. Joyce]

The purpose of this study, led by Dr. Nina R. Joyce, an alumnus of the department of epidemiology doctoral program and a current post-doctoral fellow in the department of health care policy at Harvard Medical School, was to identify patterns of use and predictors of nonadherence to lipid-lowering therapy in children aged 8 to 20 years and the subgroup with dyslipidemia.

For the purposes of this study, nonadherence to lipid-lowering therapy was defined as a gap of >90 days between the last dispensing plus the medication days supply and the next dispensing or censoring. Of the 8,710 patients meeting inclusion criteria, 87 percent were found to be nonadherent to lipid-lowering therapy. Statins were the most common index prescription, and patients with an index statin dispensing were more likely to have multiple comorbidities and other prescription drug use. Non-adherence was inversely associated with dyslipidemia, chronic kidney disease, and higher outpatient and inpatient use. When analyses were limited to patients with dyslipidemia, non-adherence was related to age and obesity.

The results of this study indicate that, despite recommendations to begin continuous treatment early for high-risk children, nonadherence to lipid-lowering therapy is frequent in this population, with modestly higher adherence in children with dyslipidemia.

This study was published in Journal of Clinical Lipidology, Volume 10, Issue 4.

To read more: http://www.ncbi.nlm.nih.gov/pubmed/27578113