Apparent discontinuation rates in patients prescribed lipid-lowering drugs

Med J Aust. 1996 Feb 19;164(4):208-11. doi: 10.5694/j.1326-5377.1996.tb94138.x.


Objective: To evaluate apparent discontinuation rates in patients newly prescribed lipid-lowering drugs.

Design and setting: A prospective survey of 12 months' dispensing data in 138 community pharmacies across metropolitan Sydney.

Patients: 610 adults (49% men) with a mean age of 58 years; 91% of prescriptions were from general practitioners; prescribed drugs were simvastatin (54%), pravastatin (31%) and gemfibrozil (15%).

Main outcome measure: The number of patients failing to collect prescription refills.

Results: 60% of patients (95% confidence interval [CI], 56%-64%) apparently discontinued their medication over 12 months. Half of the apparent discontinuations occurred within three months and a quarter within one month of starting treatment. The predominant reasons for discontinuation were: patient unconvinced about need for treatment (32%), poor efficacy (32%) and adverse events (7%). Only half of those experiencing poor efficacy were switched to another drug. The relative risk (RR) of discontinuation was lower in older patients (age 65+ v. <50 years: RR 0.66; 95% CI 0.47-0.93) and in those using other cardiovascular drugs (RR 0.69; CI 0.56-0.86), but was increased in those showing early evidence of poor compliance (RR 1.77; CI 1.33-2.35). Discontinuation appeared to be unrelated to sex, the source of the prescription (general practitioner or specialist), past use of lipid-lowering drugs or the cost of medication.

Conclusions: High apparent discontinuation rates with lipid-lowering drugs suggest significant wastage of resources in treatments that are initiated but not continued and a lost opportunity for heart disease prevention. Many patients appear to discontinue therapy for illogical reasons and this may be amenable to intervention.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Community Pharmacy Services
  • Drug Utilization
  • Female
  • Humans
  • Hypolipidemic Agents / adverse effects
  • Hypolipidemic Agents / therapeutic use*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • New South Wales
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Product Surveillance, Postmarketing
  • Prospective Studies
  • Treatment Refusal* / psychology
  • Treatment Refusal* / statistics & numerical data
  • Urban Health


  • Hypolipidemic Agents