Identifying clusters of adherence to cardiovascular risk reduction behaviors and persistence with medication in new lipid-lowering drug users. Impact on healthcare utilization

Malo, Sara (Universidad de Zaragoza) ; Rabanaque, María José (Universidad de Zaragoza) ; Maldonado, Lina (Universidad de Zaragoza) ; Moreno-Franco, Belén (Universidad de Zaragoza) ; Chaure-Pardos, Armando ; Lallana, María Jesús ; Rodrigo, María Pilar ; Aguilar-Palacio, Isabel (Universidad de Zaragoza)

Resumen: We sought to identify specific profiles of new lipid-lowering drug users based on adherence to a healthy lifestyle and persistence with medication, and to characterize co-morbidities, co-treatments, and healthcare utilization for each of the profiles identified. Observational study in 517 participants in the Aragon Workers’ Health Study (AWHS) without previous cardiovascular disease (CVD) and who initiated lipid-lowering therapy. Data were collected from workplace medical examinations and administrative health databases (2010– 2018). Using cluster analysis, we identified distinct patient profiles based on persistence with therapy and lifestyle. We then compared characteristics, morbidity, and healthcare utilization across clusters. Participants were aggregated into four clusters based on persistence with therapy, smoking status, adherence to Mediterranean diet, and physical activity. In cluster 1 (n = 113), comprising those with a healthiest lifestyle (14.2% smokers, 84.0% with medium-high adherence to Mediterranean diet, high physical activity), 16.8% were persistent. In cluster 3 (n = 108), comprising patients with the least healthy lifestyle (100% smokers, poor adherence to the Mediterranean diet, low level of physical activity), all were non-persistent. Clusters 2 (n = 150) and 4 (n = 146) both comprised patients with intermediate lifestyle be-haviors, but differed in terms of persistence (100 and 0%, respectively). Compared with other clusters, the burden of morbidity, cardiovascular score, and healthcare utilization were lower in cluster 1. The healthy adherer effect was only observed in new lipid-lowering drug users of certain profiles. Furthermore, we found that differences in adherence to lifestyle and medication recommendations for CVD prevention influenced morbidity burden and healthcare utilization.

Idioma: Inglés

DOI: 10.3390/nu13030723

Año: 2021

Publicado en: Nutrients 13, 3 (2021), 723 [14 pp.]
ISSN: 2072-6643

Factor impacto JCR: 6.706 (2021)

Categ. JCR: NUTRITION & DIETETICS rank: 15 / 90 = 0.167 (2021) - Q1 - T1

Factor impacto CITESCORE: 7.9 - Nursing (Q1) - Agricultural and Biological Sciences (Q1)

Factor impacto SCIMAGO: 1.287 - Nutrition and Dietetics (Q1) - Food Science (Q1)

Financiación: info:eu-repo/grantAgreement/ES/ISCIII-FEDER-FIS/PI17-01704

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Área Métodos Cuant.Econ.Empres (Dpto. Economía Aplicada)
Área (Departamento): Área Medic.Prevent.Salud Públ. (Dpto. Microb.Ped.Radio.Sal.Pú.)