Work

Medication persistence trajectories among individuals prescribed lipid‐lowering therapy in primary care settings: A retrospective cohort study

Year: 2025

Type: article

Abstract: Aims This study aimed to identify distinct trajectories of lipid‐modifying medication (LMM) persistence over time and to explore characteristics associated with each pattern. Methods Using primary care data from IQVIA, we conducted a retrospective cohort study of adults prescribed LMMs between January 2015 and December 2017, with 5 years of follow‐up. Persistence was defined as ≥1 prescription every 6 months. Group‐based trajectory modelling identified medication persistence patterns; characteristics were compared using 1‐way ANOVA and chi‐squared tests. Results Among 51 504 individuals (mean age 62 years, 53% male), 4 distinct trajectories were identified: persistent use (PU, 20%), gradual decline (10%), rapid decline (29%) and early discontinuation (41%). Compared to those who discontinued early, individuals in the rapid decline, gradual decline and PU groups were older by 1.18 (95% confidence interval: 0.82–1.55), 2.61 (2.08–3.13) and 3.71 (3.30–4.12) years, respectively. Persistent users were more likely to have cardiovascular risk factors: a higher proportion of smokers (44.4 vs . 39.6%), elevated systolic blood pressure (≥140 mmHg: 36.9 vs . 32.9%) and reduced renal function (estimated glomerular filtration rate >45 mL/min/m 2 : 14.4 vs . 11.7%) compared to those who discontinued LMMs early. In contrast, the early discontinuation group had a greater proportion of metropolitan residents (76.1 vs . 69.2%) and individuals with elevated total cholesterol ratios (>4: 60.8 vs . 53.8%) than the PU group. Conclusions Distinct profiles across trajectories highlight the need for tailored interventions to improve long‐term medication use, particularly among younger, healthier individuals and those residing in metropolitan areas.

Source: British Journal of Clinical Pharmacology

DOI: 10.1002/bcp.70170