Factors affecting adherence to lipid-lowering drugs: a scoping review

Objectives: Dyslipidaemia is an important risk factor of cardiovascular disease. In developed countries, only 50% of patients who had chronic illness adhere to their long-term therapy. This article aimed to review the factors affecting adherence to lipid-lowering drugs (LLD). Methods: The articles search were selected based on the available keywords in the title and abstract with the publication restricted between January 2010 to September 2020. Articles generated from the databases must fulfil both inclusion and exclusion criteria in the present systematic review. A total of 221 literature reviews obtained from the initial search. After the exclusion of the articles with irrelevant topics, a total of 23 articles were chosen for this current review. Results: The factors were classified based on three main factors which were patient related, medication related and health- care workers related factors. For patient related factors, this review found gender, age, number of family members, education level, post-hospitalization, comorbidities & CVD risk, follow-up status, occupation, socio-economy, insurance, perception, ethnicity and health plan were among factors affecting adherence to LLD. As for medication related factors, timing, polypharmacy, duration of treatment, generic medication, intensity of medication, side effects, initiating dose, packaging, drug dosing and type of drugs were revealed as contributing factors. In the light of healthcare workers related, factors shown were counselling, medication optimisation, type of provider, and location of hospital. Conclusions: Recommendations to improve adherence include educating patients on the disease itself and the importance of the treatment, modification of the dosing, timing and type of lipid-lowering drugs, and effective consultations by healthcare workers. Further studies need to be done in Malaysia as there is inadequate research on this particular topic