Factors associated with low compliance with lipid-lowering drugs in hyperlipidemic patients

Background: Treatment with lipid-lowering drugs decreases the risk of havin g a cardiovascular event by 30% according to several large intervention tri als. However, both in these trials and in clinical practice the rate of dis continuation of medical treatment and the frequency of low compliance are h igh. Objective: The purpose of the study was to determine factors associated wit h poor compliance. Methods: We studied 193 hyperlipidemic subjects who had been referred to an out-patient clinic and who were treated with at least one antihyperlipidem ic drug. The patients were asked to fill in a questionnaire which explored various factors that could possibly affect compliance. Compliance was evalu ated by the percentage of pills missed during the previous month according to patient interview. Results: Younger subjects and smokers were less compliant. Perception of fr equent side-effects to the current antihyperlipidemic treatment and high nu mber of medications were inversely correlated with compliance (P = 0.0237 a nd P = 0.0311, respectively). Frequent breaking of appointments with a phys ician were inversely correlated with compliance (P = 0.026). The patient's perception of the time that the physician spent to explain and to discuss t he different aspects of cholesterol and cardiovascular disease (CVD) was co rrelated with a higher compliance (P = 0.0125). Patients' perception of the efficacy of antihyperlipidemic therapy to prevent a CVD event in the futur e was also strongly associated with adherence to treatment (P < 0.001). Conclusions.. Many factors affect compliance with antihyperlipidemic drug t herapy. Good doctor-patient relationship, conviction of the efficacy of tre atment and increased age are associated with compliance. Perceived high fre quency of side-effects and prescription of numerous drugs negatively affect compliance.