Determinants of Non-Adherence to the Medications for Dyslipidemia: A Systematic Review

João Lopes,1 Paulo Santos1,2 1Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal; 2CINTESIS - Center for Health Technology and Services Research, University of Porto, Porto, PortugalCorrespondence: João LopesDepartment of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, Porto, 4200-319, PortugalTel +351 220426600Email joaomoraislopes@gmail.comPurpose: Dyslipidemia is a major cardiovascular risk factor, and its control leads to less cardiovascular events. Many patients will need some medications to achieve ideal targets. Non-adherence to medications is a complex problem with high impact on their effectiveness. This study aims to identify the determinants of non-adherence to medications in patients with dyslipidemia.Patients and Methods: We conducted a systematic review. PubMed and Scopus databases were searched for original articles, published between 2000 and 2020, using the MeSH terms “Dyslipidemias” and “Medication Adherence”.Results: From the initial 3502 identified articles, we selected 46 to include in the final qualitative synthesis. The determinants associated with non-adherence were lower age (≤ 50 years), female sex, African American ethnicity, smoking habits, being a new user of lipid-lowering medications, reporting or having concerns about lipid-lowering medication side effects and some comorbidities (chronic obstructive pulmonary disease, Alzheimer’s disease/dementia, depression and diabetes). On the contrary, adherence is higher in older patients, alcohol drinking habits, taking β-blockers, having a higher number of comorbidities, having a history of cardiovascular events, cardiac interventions or revascularization procedures, having health insurance and having more provider follow-up visits.Conclusion: There are important identifiable determinants of non-adherence in patients with dyslipidemia. These patients benefit from a specific approach to minimize the problem and maximize the potential benefit of the prescription.Keywords: medication adherence, dyslipidemias, causality, epidemiologic factors, heart disease risk factor