Poor adherence with hypolipidemic drugs: A lost opportunity

All articles assessing adherence to hypolipidemic drugs were reviewed and c ategorized by patient population (clinical trial, unselected) and reported as rates of nonadherence and discontinuation. Overall, levels of discontinu ation reported in clinical trials (6-31%) and lipid clinics (2-38%) are sim ilar, with unselected populations consistently reporting higher rates (15-7 8%). Rates of nonadherence in clinical trials and lipid clinics also are co mparable, with unselected populations having the highest rates. Across all settings, rates of discontinuation and nonadherence are consistently report ed to be poorer with resins and niacin than with hydroxy-6-methylalutamate coenzyme A reductase inhibitors. Adherence to hypolipidemic agents appears to decrease in parallel with level of follow-up. Data evaluating mechanisms of poor adherence are limited. While the search for new, efficacious thera pies must continue, efforts focused on improving adherence to proven therap y may have a greater overall impact on health than any single new agent.