Association between trajectories of statin adherence and subsequent cardiovascular events

Trajectory models have been shown to identify groups of patients with similar patterns of medication filling behavior and summarize the trajectory, the average adherence in each group over time. However, the association between adherence trajectories and clinical outcomes remains unclear. This study investigated the association between 12-month statin trajectories and subsequent cardiovascular events. We identified patients with insurance coverage from a large national insurer who initiated a statin during January 1, 2007 to December 31, 2010. We assessed medication adherence during the 360 days following initiation and grouped patients based on the proportion of days covered (PDC) and trajectory models. Among 519,842 statin initiators, 8,777 had a cardiovascular event during follow-up. More consistent medication use was associated with a lower likelihood of clinical events, whether adherence was measured through trajectory groups or PDC. In conclusion, statin adherence trajectory predicted future cardiovascular events better than measures categorizing PDC.

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