Association between Exposure to Statin Choice and Adherence to Statins: An Observational Cohort Study Article Swipe
Kathryn A. Martinez
,
Víctor M. Montori
,
Fátima Rodríguez
,
Larisa G. Tereshchenko
,
Jeffrey D. Kovach
,
Christopher Boyer
,
H. Hurwitz
,
Michael B. Rothberg
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1177/0272989x251346508
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1177/0272989x251346508
Background Statin Choice is a shared decision-making encounter tool embedded in the electronic health record. Objective To describe the association between the use of Statin Choice, statin prescriptions by clinicians, prescription fills (primary adherence), and statin adherence at 12 mo (secondary adherence). Design Observational cohort study at the Cleveland Clinic Health System. Subjects Statin-naïve adults aged 40 to 75 y with a 10-y atherosclerotic cardiovascular disease (ASCVD) risk of ≥5% and a primary care appointment between January 2020 and July 2021. Main Measures The primary exposure was the use of Statin Choice during a clinical encounter. We measured whether the use of Statin Choice was associated with statin prescriptions. We measured statin adherence based on pharmacy fill data at 60 d (primary adherence) and 12 mo (secondary adherence). We used mixed-effects logistic regression to estimate the adjusted odds of statin prescriptions and adherence at the 3 time points by the use of Statin Choice. Key Results Among 17,001 statin-naïve patients, 13% viewed Statin Choice and 7% were prescribed a statin. The median ASCVD risk was 10%. Patients who were shown Statin Choice had 9.04 higher odds of being prescribed a statin compared with patients not shown Statin Choice (95% confidence interval [CI]: 7.86–10.4). Among patients prescribed a statin, the use of Statin Choice was associated with 5.75 higher odds of primary adherence compared with usual care (95% CI: 4.22–7.83). At 12 mo, Statin Choice use was significantly associated with adherence in the unadjusted analysis (OR: 1.58; 95% CI: 1.05–2.08) but was not significant after adjustment for patient factors. Patients shown Statin Choice had an average of 12 mg/dL reduction in low-density lipoprotein cholesterol at 12 mo (95% CI: −16 mg/dL, −10) compared with those not shown Statin Choice. Conclusion In this observational study, Statin Choice use was strongly associated with statin prescription and fills and weakly associated with adherence to statins for up to 1 y. A randomized trial is needed to confirm causality. Highlights Statin Choice is an electronic health record–embedded shared decision-making encounter tool available for free in many health care systems. Small randomized controlled trials have found modest associations between the use of Statin Choice and statin adherence using patient-reported data. In our large study using pharmacy fill data, clinician use of Statin Choice during a medical encounter was associated with significantly greater patient adherence with statins up to 1 y later. Exposure to Statin Choice was associated with a significant reduction in low-density lipoprotein cholesterol over 1 y.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1177/0272989x251346508
- OA Status
- green
- Cited By
- 2
- References
- 22
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4411604858
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4411604858Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1177/0272989x251346508Digital Object Identifier
- Title
-
Association between Exposure to Statin Choice and Adherence to Statins: An Observational Cohort StudyWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2025Year of publication
- Publication date
-
2025-06-24Full publication date if available
- Authors
-
Kathryn A. Martinez, Víctor M. Montori, Fátima Rodríguez, Larisa G. Tereshchenko, Jeffrey D. Kovach, Christopher Boyer, H. Hurwitz, Michael B. RothbergList of authors in order
- Landing page
-
https://doi.org/10.1177/0272989x251346508Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
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greenOpen access status per OpenAlex
- OA URL
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https://www.ncbi.nlm.nih.gov/pmc/articles/12354097Direct OA link when available
- Concepts
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Statin, Medicine, Odds ratio, Medical prescription, Observational study, Internal medicine, Confidence interval, Cohort study, Cohort, Retrospective cohort study, Logistic regression, Physical therapy, PharmacologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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2Total citation count in OpenAlex
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2025: 2Per-year citation counts (last 5 years)
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22Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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| sustainable_development_goals[0].display_name | Peace, Justice and strong institutions |
| citation_normalized_percentile.value | 0.9556 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | True |