Identifying Clusters of Adherence to Cardiovascular Risk Reduction Behaviors and Persistence with Medication in New Lipid-Lowering Drug Users. Impact on Healthcare Utilization
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 participan...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-02-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/13/3/723 |
| _version_ | 1797395374237810688 |
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| author | Sara Malo María José Rabanaque Lina Maldonado Belén Moreno-Franco Armando Chaure-Pardos María Jesús Lallana María Pilar Rodrigo Isabel Aguilar-Palacio |
| author_facet | Sara Malo María José Rabanaque Lina Maldonado Belén Moreno-Franco Armando Chaure-Pardos María Jesús Lallana María Pilar Rodrigo Isabel Aguilar-Palacio |
| author_sort | Sara Malo |
| collection | DOAJ |
| description | 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 (<i>n</i> = 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 (<i>n</i> = 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 (<i>n</i> = 150) and 4 (<i>n</i> = 146) both comprised patients with intermediate lifestyle behaviors, 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. |
| first_indexed | 2024-03-09T00:33:32Z |
| format | Article |
| id | doaj.art-7c910e701cd446eba0c4b8ca759de013 |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-09T00:33:32Z |
| publishDate | 2021-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-7c910e701cd446eba0c4b8ca759de0132023-12-11T18:19:49ZengMDPI AGNutrients2072-66432021-02-0113372310.3390/nu13030723Identifying Clusters of Adherence to Cardiovascular Risk Reduction Behaviors and Persistence with Medication in New Lipid-Lowering Drug Users. Impact on Healthcare UtilizationSara Malo0María José Rabanaque1Lina Maldonado2Belén Moreno-Franco3Armando Chaure-Pardos4María Jesús Lallana5María Pilar Rodrigo6Isabel Aguilar-Palacio7Department of Preventive Medicine and Public Health, University of Zaragoza, 50009 Zaragoza, SpainDepartment of Preventive Medicine and Public Health, University of Zaragoza, 50009 Zaragoza, SpainFundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, SpainDepartment of Preventive Medicine and Public Health, University of Zaragoza, 50009 Zaragoza, SpainDepartment of Preventive Medicine and Public Health, University of Zaragoza, 50009 Zaragoza, SpainFundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, SpainGrupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), SpainDepartment of Preventive Medicine and Public Health, University of Zaragoza, 50009 Zaragoza, SpainWe 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 (<i>n</i> = 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 (<i>n</i> = 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 (<i>n</i> = 150) and 4 (<i>n</i> = 146) both comprised patients with intermediate lifestyle behaviors, 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.https://www.mdpi.com/2072-6643/13/3/723cardiovascular diseaseprimary preventionmedication adherencehealthy lifestyleworkplace |
| spellingShingle | Sara Malo María José Rabanaque Lina Maldonado Belén Moreno-Franco Armando Chaure-Pardos María Jesús Lallana María Pilar Rodrigo Isabel Aguilar-Palacio Identifying Clusters of Adherence to Cardiovascular Risk Reduction Behaviors and Persistence with Medication in New Lipid-Lowering Drug Users. Impact on Healthcare Utilization Nutrients cardiovascular disease primary prevention medication adherence healthy lifestyle workplace |
| title | Identifying Clusters of Adherence to Cardiovascular Risk Reduction Behaviors and Persistence with Medication in New Lipid-Lowering Drug Users. Impact on Healthcare Utilization |
| title_full | Identifying Clusters of Adherence to Cardiovascular Risk Reduction Behaviors and Persistence with Medication in New Lipid-Lowering Drug Users. Impact on Healthcare Utilization |
| title_fullStr | Identifying Clusters of Adherence to Cardiovascular Risk Reduction Behaviors and Persistence with Medication in New Lipid-Lowering Drug Users. Impact on Healthcare Utilization |
| title_full_unstemmed | Identifying Clusters of Adherence to Cardiovascular Risk Reduction Behaviors and Persistence with Medication in New Lipid-Lowering Drug Users. Impact on Healthcare Utilization |
| title_short | Identifying Clusters of Adherence to Cardiovascular Risk Reduction Behaviors and Persistence with Medication in New Lipid-Lowering Drug Users. Impact on Healthcare Utilization |
| title_sort | identifying clusters of adherence to cardiovascular risk reduction behaviors and persistence with medication in new lipid lowering drug users impact on healthcare utilization |
| topic | cardiovascular disease primary prevention medication adherence healthy lifestyle workplace |
| url | https://www.mdpi.com/2072-6643/13/3/723 |
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