Compliance with and efficacy of treatment with pravastatin and cholestyramine : a randomized study on lipid-lowering in primary care.
Lipid-lowering drugs as 3-hydroxy-3-methyl glutaryl coenzyme A (HMG-CoA) reductase inhibitors and cholestyramine are effective in reducing cardiovascular morbidity both in primary and secondary prevention.
Patient compliance is an important determinant of the outcome of therapy.
This study was designed to compare compliance with tolerance and lipid-lowering effectiveness of pravastatin and/or cholestyramine in primary care.
Nine hundred and eighty nine women and 1047 men were randomized to treatment at 100 primary-care centres in Sweden.
After dietary intervention, an eligible patient was randomly assigned to one of four programs of daily treatment : group Q, 16 g cholestyramine, group QP, 8 g cholestyramine and 20 mg pravastatin, group P20,20 mg pravastatin or group P40,40 mg pravastatin.
In group Q, group QP, group P20 and group P40 the reductions in low density lipoprotein (LDL) - cholesterol were 26%, 36%, 27% and 32%. The dose actually taken was 91-95% of the prescribed for the pravastatin treatment groups and 77-88% for the cholestyramine groups.
In the pravastatin and cholestyramine groups 76-78% and 44-53%, respectively, completed the trial.
Only 8-27% of the patients reached a serum cholesterol target level of 5.2 mmol L'There was no difference in lipid-lowering effect between women and men.
Pravastatin alone is efficacious and compliance is high, independent of dose. (...)
Mots-clés Pascal : Cholestérolémie, Randomisation, Observance médicamenteuse, Pravastatine, Colestyramine, Facteur efficacité, Soin intégré, Homme, Norvège, Europe, Métabolisme pathologie, Lipide, Hypolipémiant, Inhibiteur enzyme, Hydroxymethylglutaryl-CoA reductase, Oxidoreductases, Enzyme
Mots-clés Pascal anglais : Cholesterolemia, Randomization, Drug compliance, Pravastatin, Colestyramine, Effectiveness factor, Managed care, Human, Norway, Europe, Metabolic diseases, Lipids, Antilipemic agent, Enzyme inhibitor, Hydroxymethylglutaryl-CoA reductase, Oxidoreductases, Enzyme
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0290774
Code Inist : 002B02N. Création : 27/11/1998.