- In adults with type 1 diabetes (T1D), high refill adherence to lipid-lowering treatment (LLT) is associated with a lower risk for nonfatal cardiovascular disease (CVD), while discontinuation is linked to increased risk.
Why this matters
- Role of LLT adherence in T1D has not been well-studied.
- Swedish retrospective nationwide study of 6192 adults with T1D, followed from 2006-2010 through 2013.
- Refill adherence was calculated by medication possession ratio (MPR).
- Funding: Grants from the Swedish state.
- Mean MPR over 18 months was 72% during 18-month exposure assessment period.
- 52% participants had MPR >80%.
- 27% discontinued LLT.
- Mean follow-up: of 3.6 years for nonfatal events; 3.9 years for fatal events.
- During follow-up: 637 nonfatal CVD events, 58 fatal CVD events, and 302 deaths for other causes.
- Patients with MPR >80% had a 22% lower risk for nonfatal CVD compared with patients with MPR ≤80%.
- Patients discontinuing LLT had a 43% higher risk for nonfatal CVD.
- Those with MPR >80% had a nonsignificantly increased risk for fatal CVD (HR, 1.96; P=.06).
- Observational study, residual confounding possible.
- Adherence after prescription fills unknown.
- Healthier people may be more adherent.
- People with multiple medications dispensed were excluded.