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Persistence in the use of statins and the associated outcomes among Chinese patients with high risk for coronary heart disease.

Cheng Wai Ring Caroline. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (leaves 74-84). / Abstracts in English and Chinese. / Acknowledgement --- p.i / Abstract --- p.ii / 摘要 --- p.iv / Table of contents --- p.vi / Publications --- p.x / List of figures --- p.xi / List of tables --- p.xii / Abbreviations --- p.xiii / Chapter Chapter 1 --- Introduction / Chapter 1.1 --- Coronary Heart Disease --- p.2 / Chapter 1.1.1 --- Epidemiology --- p.2 / Chapter 1.2 --- Hypercholesterolemia and CHD --- p.3 / Chapter 1.2.1 --- Atherosclerotic plaque and lipoprotein --- p.4 / Chapter 1.2.2 --- NCEP ATP III guidelines --- p.5 / Chapter 1.2.2.1 --- CHD risk assessment --- p.5 / Chapter 1.2.2.2 --- Target lipid control --- p.8 / Chapter 1.2.2.3 --- Therapeutic lifestyle changes --- p.9 / Chapter 1.2.2.4 --- Pharmacological interventions --- p.10 / Chapter 1.2.2.5 --- Adherence to lipid-lowering therapy --- p.13 / Chapter 1.3 --- Adherence to drug therapy --- p.14 / Chapter 1.3.1 --- Definition of adherence --- p.14 / Chapter 1.3.2 --- Methods to assess adherence --- p.16 / Chapter 1.3.2.1 --- Expressions of adherence measurements --- p.20 / Chapter 1.3.3 --- Time effect on adherence --- p.21 / Chapter 1.3.4 --- Predictors of adherence --- p.22 / Chapter 1.3.5 --- Impact of poor adherence to statins --- p.23 / Chapter 1.4 --- Objectives and hypotheses --- p.25 / Chapter Chapter 2 --- Materials and Methods / Chapter 2.1 --- Study site --- p.27 / Chapter 2.2 --- Patient selection criteria --- p.28 / Chapter 2.2.1 --- Inclusion criteria --- p.28 / Chapter 2.2.2 --- Exclusion criteria --- p.29 / Chapter 2.3 --- Patient recruitment --- p.30 / Chapter 2.4 --- Assessments --- p.32 / Chapter 2.4.1 --- Adherence assessment --- p.32 / Chapter 2.4.1.1 --- Electronic monitoring --- p.32 / Chapter 2.4.1.2 --- Patient report --- p.33 / Chapter 2.4.1.3 --- Pill count --- p.34 / Chapter 2.4.1.4 --- Predictors of adherence --- p.34 / Chapter 2.4.2 --- Clinical outcome assessment --- p.35 / Chapter 2.4.2.1 --- Lipid control --- p.35 / Chapter 2.4.3 --- Economic outcome assessment --- p.35 / Chapter 2.4.3.1 --- Total direct medical cost --- p.35 / Chapter 2.4.3.2 --- Healthcare cost per member per month --- p.36 / Chapter 2.5 --- Sample size --- p.36 / Chapter 2.6 --- Statistical analysis --- p.37 / Chapter Chapter 3 --- Results / Chapter 3.1 --- Study sample --- p.40 / Chapter 3.1.1 --- Demographic characteristics --- p.41 / Chapter 3.1.2 --- Co-morbidity factors --- p.42 / Chapter 3.2 --- Adherence measurement --- p.44 / Chapter 3.2.1 --- Electronic monitoring --- p.44 / Chapter 3.2.2 --- Patient report --- p.45 / Chapter 3.2.3 --- Pill Count --- p.46 / Chapter 3.2.4 --- Correlation among methods for measuring adherence --- p.47 / Chapter 3.2.5 --- Trend of adherence and persistence over time --- p.48 / Chapter 3.2.6 --- Independent predictors of adherence --- p.49 / Chapter 3.3 --- Outcome assessment --- p.52 / Chapter 3.3.1 --- Clinical outcomes --- p.52 / Chapter 3.3.2 --- Economic outcomes --- p.52 / Chapter 3.4 --- Association between adherence and clinical outcomes --- p.53 / Chapter 3.4.1 --- Adherence and LDL-C reduction --- p.53 / Chapter 3.4.2 --- Adherence and NCEP ATP III target --- p.55 / Chapter 3.5 --- Association between adherence and economic outcomes --- p.55 / Chapter 3.5.1 --- Adherence and healthcare utilization --- p.55 / Chapter Chapter 4 --- Discussion and Conclusion / Chapter 4.1 --- Discussion --- p.59 / Chapter 4.1.1 --- Accuracy of patient report and pill count --- p.59 / Chapter 4.1.2 --- Persistence to statin therapy over time --- p.62 / Chapter 4.1.3 --- Predictors for patient adherence --- p.63 / Chapter 4.1.4 --- Clinical impacts of patient adherence --- p.66 / Chapter 4.1.5 --- Economic impacts of patient adherence --- p.68 / Chapter 4.1.6 --- Limitations --- p.70 / Chapter 4.2 --- Conclusion --- p.71 / References --- p.74 / Appendices / Appendix A-1. Framingham risk scoring system for male --- p.86 / Appendix A-2. Framingham risk scoring system for female --- p.87 / Appendix B-1. Information sheet provided to nurses of the Cardiology clinic --- p.88 / Appendix B-2. Information sheet provided to nurses of the Diabetes clinic --- p.89 / Appendix B-3. Information sheet provided to nurses of the Lipid clinic --- p.90 / Appendix C. Data collection form --- p.91 / Appendix D. Instruction sheet provided to the study patient --- p.94 / Appendix E. Unit cost of items from electronic dispensing record and Hong Kong Gazette 2003 for estimating total direct medical cost --- p.95

Identiferoai:union.ndltd.org:cuhk.edu.hk/oai:cuhk-dr:cuhk_324652
Date January 2004
ContributorsCheng, Wai Ring Caroline., Chinese University of Hong Kong Graduate School. Division of Pharmacy.
Source SetsThe Chinese University of Hong Kong
LanguageEnglish, Chinese
Detected LanguageEnglish
TypeText, bibliography
Formatprint, xv, 95 leaves : ill. ; 30 cm.
CoverageChina, Hong Kong, Hong Kong
RightsUse of this resource is governed by the terms and conditions of the Creative Commons “Attribution-NonCommercial-NoDerivatives 4.0 International” License (http://creativecommons.org/licenses/by-nc-nd/4.0/)

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