Comprehensive efforts to increase adherence to statin therapy.

Previous work from the European Society of Cardiology (ESC), the European Atherosclerosis Society (EAS) and from other groups has addressed the benefits of statin treatment in different patient populations.1–4 Unfortunately, adherence to guideline-recommended statin therapy is suboptimal: Statins are underused and LDL cholesterol targets are not met in up to 80% of high-risk patients.5–7Excellent reviews have recently been published on the issue of statin intolerance and some lay media as well strongly emphasize this issue.8 True and verified statin intolerance, however, is uncommon and is not the main reason for poor adherence to statin treatment. Because poor adherence to statin treatment in turn is extremely common, it appears necessary to discuss the problem of statin adherence in a broader context and to develop strategies to overcome it. This clinically important task has not yet been the focus of a review or practice recommendation and therefore is the aim of the present position paper from the ESC working group on Cardiovascular Pharmacotherapy.This work takes the position that statin therapy is underutilized because of non-adherence not solely related to statin side effects and proposes steps to be taken in cardiovascular practice to improve statin adherence and thus cardiovascular outcomes. Our article aims to highlight the scientific background that helps to (i) overcome statin non-adherence by definition and description of true adverse statin effects, (ii) increase statin adherence by changing reservation against lipid lowering in media and the public, and (iii) guide efforts in the scientific community to close the gap between knowledge and practice of lipid management.Although statins are generally well-tolerated, statin adherence is poor in clinical practice: A survey of statin prescription claims showed a 30% discontinuation rate within the first year following initial prescription for primary prevention in USA.9 Data from the Danish …