Provider recommendations for patient-reported muscle symptoms on statin therapy: Insights from the Understanding Statin Use in America and Gaps in Patient Education survey.

Abstract

BACKGROUND:

Statin-associated muscle symptoms are reported by 10% to 29% of patients in clinical practice and are a major determinant of statin nonadherence, discontinuation, and switching. Little is known about what advice patients receive from their providers when dealing with these symptoms.

OBJECTIVE:

The objective of the study was to assess patient's reports of provider advice when experiencing new or worsened muscle symptoms while taking a statin.

METHODS:

Data were analyzed from the Understanding Statin Use in America and Gaps in Education survey, a self-administered internet-based survey of 10,138 adults with a reported history of high cholesterol and statin use.

RESULTS:

Of the respondents, 60% of former statin users (n = 1220) reported ever experiencing new or worsened muscle pain on a statin, in contrast to 25% of current users (n = 8918; P < .001). Former statin users reported stopping more statins because of muscle symptoms (mean ± standard deviation, 2.2 ± 1.7) compared with current users (mean 1.6 ± 1.5, P < .0001). For those with muscle-related symptoms while on a statin, participants reported that providers most often suggested switching to another statin (33.8%), stopping the statin (15.9%), continuing the statin with further monitoring of muscle symptoms (12.2%), reducing the statin dose (9.8%), or getting a blood test for signs of muscle damage (9.2%). A lower percentage were advised to add either vitamin D (7.0%) or coenzyme Q10 (5.8%), or to switch to nonstatin therapy (6.1%) or red yeast rice (2.6%).

CONCLUSIONS:

This study highlights patient experience with statin-associated muscle symptoms and the strategies recommended by providers in managing these symptoms. More research is needed to develop patient-centric and evidence-based approaches to managing statin-associated muscle symptoms, which is especially important in light of recent data showing increased cardiovascular risk among those who discontinue statin therapy.

• Authors: Terry A Jacobson, Abdullah Khan, Kevin C Maki, Eliot A Brinton, Jerome D Cohen
• Journal: Journal of clinical lipidology (J Clin Lipidol) 2018 Jan - Feb Vol. 12 Issue 1 Pg. 78-88 ISSN: 1933-2874 [Print] United States
• PMID: 29239815 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2017 National Lipid Association. Published by Elsevier Inc. All rights reserved.

Chemical References

• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Ubiquinone
• Vitamin D
• coenzyme Q10

Topics

• Aged
• Americas
• Dietary Supplements
• Female
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (adverse effects, therapeutic use)
• Hypercholesterolemia (drug therapy, psychology)
• Internet
• Male
• Middle Aged
• Myalgia (etiology)
• Self Report
• Surveys and Questionnaires
• Ubiquinone (administration & dosage, analogs & derivatives)
• Vitamin D (administration & dosage)