Elsevier

Journal of Clinical Lipidology

Volume 6, Issue 3, May–June 2012, Pages 208-215
Journal of Clinical Lipidology

Original Article
Understanding Statin Use in America and Gaps in Patient Education (USAGE): An internet-based survey of 10,138 current and former statin users

https://doi.org/10.1016/j.jacl.2012.03.003Get rights and content

Background

Statins substantially reduce the risk of cardiovascular disease and are generally well-tolerated. Despite this, many patients discontinue therapy. A better understanding of the characteristics of current and former statin users may be helpful for formulating strategies to improve long-term adherence.

Objective

The Understanding Statin Use in America and Gaps in Education (USAGE) survey assessed the attitudes, beliefs, practices, and behavior of current and former statin users.

Methods

Individuals 18 years or older who reported a history of high cholesterol and current or former statin use were identified within a registered consumer panel cohort in the United States and invited to participate in an Internet survey.

Results

Of the 10,138 respondents, 8918 (88%) were current statin users and 1220 (12%) were former users. Participants (mean age 61 years) were predominantly white (92%), female (61%), of middle income (median $44,504/yr), and had health insurance (93%). Among current users, 95% took a statin alone, and 70% had not missed a dose in the past month. Although ∼70% reported that their physicians had explained the importance of cholesterol levels for their heart health former users were less satisfied with the discussions (65% vs. 83%, P < .05). Muscle-related side effects were reported by 60% and 25% of former and current users, respectively (P < .05). Nearly half of all respondents switched statins at least once. The primary reason for switching by current users was cost (32%) and the primary reason for discontinuation was side effects (62%).

Conclusions

This survey provides important insights into behavior and attitudes among current and former statin users and the results suggest that more effective dialogue between healthcare providers and patients may increase persistence of statin use, particularly when the patient has concerns about side effects and drug costs.

Section snippets

Study design

The USAGE Survey was conducted from September 21, 2011, through October 17, 2011, via an Internet-based, self-administered questionnaire developed by Kantar Health (New York, NY), with input from the study authors representing the National Lipid Association, as well as from Kowa Pharmaceuticals America, Inc. (Montgomery, AL), and Eli Lilly and Company (Indianapolis, IN). The survey was administered by Lightspeed Online Research, Inc. (New York, NY), a subsidiary of Kantar Health. The study

Demographic characteristics

Of the 27,946 individuals with high cholesterol identified from the Ailment Panel of Lightspeed Online Research and contacted by e-mail to participate in the survey, 15,346 (54.9%) responded, and of those, 10,138 (n = 8918 current statin users and n = 1220 former statin users) were determined to be eligible, provided consent, and completed the survey. A summary of the demographic characteristics of the respondents is shown in Table 1. In summary, the majority were white (92%) and more than half

Discussion

USAGE is, to the authors' knowledge, the largest U.S. survey of self-reported statin users. As such, it differs from other studies of statin adherence, which have analyzed large insurance and pharmacy databases.27 Although valuable, these studies contain only objective data regarding pharmacy refills and diagnoses but lack direct information regarding the patients' experiences and reasons for stopping or switching statin therapy. Thus, the USAGE survey provides new insights into the

Summary and conclusions

USAGE is the largest Internet-based survey of attitudes and observations of individuals who have taken statins. Despite the limitations to this survey, primarily the examination of a population which was not entirely typical of the general U.S. population, it provides important insights into behavior and attitudes among current and former statin users. Among current users, most reported excellent adherence to daily statin use and the majority were taking a generic statin, citing cost as a major

Financial disclosures

This study was funded by Kowa Pharmaceuticals America, Inc. (Montgomery, AL), and Eli Lilly and Company (Indianapolis, IN). The National Lipid Association was a partner in conducting the survey. None of the authors received compensation for study design, study analysis, or manuscript preparation. The authors maintained full editorial control of the manuscript content and the decision to submit for publication.

Dr. Cohen has no disclosures. Dr. Brinton has received honoraria related to speaking

Acknowledgments

More information regarding the survey and these findings is available at the USAGE consumer website (www.StatinUSAGE.com). The authors wish to acknowledge the help and support of Lewis Kopenhafer (Kantar Health); Megan Seery (National Lipid Association); Craig Sponseller, MD (Kowa Pharmaceuticals); and Mary R. Dicklin, PhD (Biofortis-Provident Clinical Research).

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