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Maintenance of statin use over 3 years following acute coronary syndromes: a national data linkage study (ANZACS-QI-2)
  1. Corina Grey1,
  2. Rod Jackson1,
  3. Sue Wells1,
  4. Simon Thornley1,
  5. Roger Marshall1,
  6. Sue Crengle2,
  7. Jeff Harrison3,
  8. Tania Riddell1,
  9. Andrew Kerr1,4
  1. 1Section of Epidemiology and Biostatistics, University of Auckland, Auckland, New Zealand
  2. 2Department of Planning and Funding, Waitemata District Health Board, Auckland, New Zealand
  3. 3School of Pharmacy, University of Auckland, Auckland, New Zealand
  4. 4Middlemore Hospital, Auckland, New Zealand
  1. Correspondence to Dr Corina Grey, Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, PO Box 92019, Auckland 1142, New Zealand; c.grey{at}auckland.ac.nz

Abstract

Objective To describe patterns of statin use and predictors of poor maintenance over a 3-year period following an acute coronary syndrome (ACS).

Methods National hospitalisation, mortality and pharmaceutical dispensing data were linked for all subjects aged 35–84 years discharged from a public hospital with an ACS in New Zealand in 2007. A Medication Possession Ratio (MPR; percentage of follow-up days patients were dispensed statins) was calculated for each patient. Adequate maintenance was defined by a MPR ≥80%.

Results In 2007, 11 348 patients aged 35–84 years were discharged from hospital with ACS. Within 90 days of discharge, 83% had received a statin. Over the follow-up period, 66% were adequately maintained on a statin (MPR ≥80%): 69% in the first year, 67% in the second year and 66% in the third year. Patients taking statins prior to admission and those who underwent a coronary procedure were 20–50% more likely to have a MPR ≥80% over 3 years than others. In contrast, people aged 35–45 years and those of Maori or Pacific ethnicity were 13–25% less likely to have a MPR ≥80% than those aged 55–64 years and Europeans.

Conclusions One-third of patients were not adequately maintained on statins over the 3-year period following ACS, but 82% of those on a statin prior to admission had an MPR ≥80% over 3 years of follow-up. These findings define achievable treatment levels and identify groups who may benefit from efforts to improve statin use.

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