Reasons for discontinuation of lipid-lowering medications in patients with chronic kidney disease

Cardiorenal Medicine
Fritha J R MorrisonAlexander Turchin

Abstract

Many patients with chronic kidney disease (CKD) do not receive lipid-lowering therapy despite their high cardiovascular risk. The reasons for this are unknown. We have conducted a retrospective cohort study of discontinuation of lipid-lowering drugs in patients with CKD stage 3 and higher treated in practices affiliated with two academic medical centers between 2000 and 2010. Information on medication discontinuation and its reasons was obtained from electronic medical records, including natural language processing of electronic notes using previously validated software. Out of 14,034 patients in the study cohort, 10,072 (71.8%) stopped their lipid-lowering drugs at least once, and 2,444 (17.4%) stopped them for at least 1 month. Patients who had a comorbidity associated with higher cardiovascular risk were less likely to stop lipid-lowering drugs. Insurance request was the most common explicitly documented reason for discontinuation, and adverse reactions were the most common reason for long-term discontinuation. In a multivariable analysis, patients were more likely to stop a lipid-lowering drug because of an insurance request if they had government insurance and they were also more likely to stop a lipid-lowering drug becaus...Continue Reading

Citations

May 28, 2019·Cardiovascular Drugs and Therapy·Efstratios KoutroumpakisRadmila Lyubarova
Apr 30, 2019·Journal of the American Medical Informatics Association : JAMIA·Feifan LiuHong Yu

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