Medication adherence and time to initiation of lipid-lowering drug dispensing by pharmacies in the Valle d'Aosta region (Italy) in patients with conditions associated with atherosclerotic cardiovascular diseases.

OBJECTIVES

Valle d'Aosta (Italy) has been recognized as the region reporting the lowest level of lipid-lowering drug use in the country, according to the Italian Medicines Agency. This retrospective, observational study investigated medication adherence and time to initiation (TTI) for lipid-lowering drug dispensing, based on medication supplies from hospital and community pharmacies, among residents of the Valle d'Aosta Region in secondary prevention of diseases associated with atherosclerotic cardiovascular disease (ASCVD) and naïve to lipid-lowering drugs.

METHODS

Anonymized data relating to drug dispensing and hospitalizations from the local health authority of the Valle d'Aosta (AUSL VdA) were collected during 2016-22. Data were used to estimate adherence to lipid-lowering drugs, measured as the medication possession ratio (MPR) and the TTI after the first hospital discharge for ASCVD-related conditions.

KEY FINDINGS: A total of 426 patients were included in the study (median age 67.0 years, 68.3% males). Adherence to lipid-lowering treatment was suboptimal, with only 43.7% of analysed patients classified as adherent during 3 years after initiation (MPR ≥ 80.0%). Among them, median TTI was 72.5 days, with only 14.1% initiating lipid-lowering drug dispensing by community pharmacies within the first week post-discharge.

CONCLUSIONS

The low consumption of lipid-lowering drugs observed in the region finds a counterpart in the context of poor adherence and of delay in therapy initiation in secondary prevention patients described by this analysis. The findings highlight the need for new strategies to mitigate ASCVD-related risks. Insights from this study may guide regional healthcare providers in implementing targeted interventions to enhance cardiovascular outcomes.