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Table 2 associations of clinical and healthcare provider factors with suboptimal statin adherence and non-persistence in patients post ASCVD discharge

From: Long-term statin adherence in patients after hospital discharge for new onset of atherosclerotic cardiovascular disease: a population-based study of real world prescriptions in Taiwan

Variable

Adjusted odds ratio

(95% CI)

Adjusted coefficient

(SE)

Adjusted hazard ratio

(95% CI)

Clinical factors

 Patient demographics

  Age at index date > 75 vs. ≤75 (y)

1.10

(1.08–1.12)

−0.026

(0.002)

1.11

(1.09–1.13)

  Female vs. male

0.96

(0.95–0.98)

0.007

(0.002)

1.00

(0.99–1.02)

Previous statin use

  Used one year prior to ASCVD

0.72

(0.71–0.74)

0.069

(0.002)

0.89

(0.86–0.93)

  Used during hospitalization

0.93

(0.91–0.95)

0.015

(0.002)

0.74

(0.72–0.75)

Diagnosis of ASCVD events

 Ischemic stroke

Ref.

(0.98–1.07)

Ref.

 

Ref.

 

 AMI without PTCA/CABG

1.03

(0.63–0.67)

0.002

(0.004)

1.06

(1.02–1.11)†

 AMI receiving revascularization

0.65

(0.69–0.73)

0.087

(0.003)

0.69

(0.67–0.71)‡

CHD receiving revascularization

0.71

(0.98–1.07)

0.075

(0.003)

0.71

(0.69–0.73)‡

Comorbidities one year before ASCVD

 Renal disease

1.29

(1.25–1.33)

−0.043

(0.003)

1.21

(1.17–1.24)

 Liver disease

1.10

(1.07–1.14)

−0.013

(0.003)

1.09

(1.06–1.12)

 Depression

1.10

(1.06–1.14)

−0.015

(0.004)

1.09

(1.06–1.12)

 COPD

1.07

(1.04–1.10)

−0.012

(0.003)

1.07

(1.04–1.09)

 Dementia

1.06

(1.01–1.12)

−0.018

(0.005)

1.05

(1.00–1.10)

 Transient ischemic attack

0.99

(0.95–1.03)

0.002

(0.004)

1.01

(0.97–1.05)

 Ischemic heart disease

0.99

(0.97–1.01)

0.004

(0.002)

0.98

(0.96–1.00)

 Cancer

1.00

(0.96–1.03)

0.004

(0.003)

0.98

(0.95–1.01)

 Hyperlipidemia

0.93

(0.91–0.95)

0.022

(0.002)

0.93

(0.91–0.95)

Medications one year before ASCVD

 Insulin

1.15

(1.12–1.18)

−0.020

(0.002)

1.11

(1.08–1.13)

 Digitalis

1.12

(1.08–1.17)

−0.022

(0.004)

1.10

(1.06–1.15)

 OADs

1.05

(1.03–1.07)

−0.007

(0.002)

1.09

(1.07–1.11)

 ACEIs

1.05

(1.03–1.07)

−0.009

(0.002)

1.05

(1.03–1.07)

 Diuretics

1.05

(1.03–1.07)

−0.011

(0.002)

1.05

(1.03–1.07)

 CCBs

1.02

(1.00–1.04)

−0.003

(0.002)

1.04

(1.03–1.06)

 Anticoagulants

0.99

(0.96–1.02)

0.003

(0.003)

0.95

(0.93–0.98)

 β-blockers

0.95

(0.93–0.96)

0.008

(0.002)

0.97

(0.95–0.98)

 ARBs

0.95

(0.93–0.97)

0.008

(0.002)

0.96

(0.94–0.97)

 Antiplatelet agents

0.94

(0.92–0.96)

0.010

(0.002)

0.93

(0.92–0.95)

Index statin used

 Dosage: moderate vs. low

0.96

(0.94–0.97)

0.010

(0.002)

0.95

(0.93–0.96)

 Dosage: high vs. low

1.03

(0.98–1.07)

0.000

(0.004)

0.97

(0.94–1.01)

 High potency vs. others

0.91

(0.89–0.93)

0.020

(0.002)

0.92

(0.90–0.94)

Healthcare provider factors

 Accreditation level of statin prescribing healthcare organization

  Primary care clinic

Ref.

 

Ref.

 

Ref.

 

  District hospital

0.88

(0.83–0.93)

−0.003

(0.006)

0.85

(0.81–0.90)

  Regional hospital

0.78

(0.74–0.83)

0.020

(0.006)

0.82

(0.78–0.86)

  Medical center

0.60

(0.56–0.63)

0.070

(0.006)

0.61

(0.58–0.64)

  Other hospital

0.76

(0.71–0.82)

0.033

(0.007)

0.80

(0.75–0.86)

Geographic location of statin prescribing healthcare organization

 Eastern region

Ref.

 

Ref.

 

Ref.

 

 Taipei region

0.90

(0.86–0.94)

0.037

(0.004)

0.89

(0.86–0.93)

 Northern region

0.87

(0.82–0.91)

0.030

(0.005)

0.87

(0.83–0.91)

 Central region

1.00

(0.95–1.05)

−0.001

(0.004)

0.97

(0.92–1.01)

 Southern region

0.83

(0.79–0.87)

0.044

(0.004)

0.81

(0.77–0.84)

 Kao-Ping region

0.84

(0.80–0.88)

0.033

(0.004)

0.84

(0.81–0.88)

Specialty of statin prescribing physician

 Others (exclude all below)

Ref.

 

Ref.

 

Ref.

 

 Cardiovascular medicine

0.53

(0.50–0.56)

0.109

(0.006)

0.62

(0.59–0.65)

 Cardiovascular surgery

0.53

(0.49–0.57)

0.107

(0.007)

0.65

(0.61–0.69)

 Metabolism and Endocrinology

0.59

(0.55–0.63)

0.115

(0.006)

0.58

(0.55–0.62)

 Neurology

0.68

(0.65–0.72)

0.065

(0.006)

0.80

(0.76–0.84)

 Internal medicine

0.77

(0.73–0.82)

0.040

(0.006)

0.89

(0.85–0.93)

 Family medicine

0.84

(0.77–0.92)

0.020

(0.008)

0.92

(0.86–0.99)

Year of index statin prescription

 2006

Ref.

 

Ref.

 

Ref.

 

 2007

0.89

(0.86–0.91)

0.024

(0.003)

0.91

(0.89–0.94)

 2008

0.83

(0.81–0.85)

0.036

(0.003)

0.86

(0.84–0.88)

 2009

0.76

(0.74–0.78)

0.048

(0.003)

0.80

(0.78–0.82)

 2010

0.72

(0.70–0.74)

0.055

(0.003)

0.75

(0.73–0.77)

 2011

0.69

(0.67–0.71)

0.059

(0.003)

0.73

(0.71–0.75)

 2012

0.49

(0.47–0.51)

0.100

(0.003)

0.69

(0.66–0.72)

  1. p-value < 0.05;p-value < 0.001. All factors were included for adjustment