{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:38:08Z","timestamp":1761093488180,"version":"build-2065373602"},"reference-count":38,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2012,7,3]],"date-time":"2012-07-03T00:00:00Z","timestamp":1341273600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2012,7]]},"abstract":"<jats:sec><jats:title>Study Objectives<\/jats:title><jats:p>To compare the cholesterol level goal attainment rates in patients receiving simvastatin doses recommended in clinical practice guidelines and simvastatin doses most frequently prescribed in clinical practice versus other statins at various dose levels, and to assess statin adherence rates in patients receiving all statins.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Source<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">PHARMO<\/jats:styled-content> database, which contains linked prescription drug information, hospitalization records, and laboratory test results of over 1 million patients in the Netherlands.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>A total of 7355 new statin users with available cholesterol level measurements before and 12\u00a0months after starting statin treatment between 1999 and 2006.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements and Main Results<\/jats:title><jats:p>Simvastatin was chosen as the reference drug because policy makers in the Netherlands have promoted the use of generically available statins to reduce costs. Cholesterol level goal attainment rates were compared in patients receiving simvastatin 40\u00a0mg\/day, which was the statin dose promoted in the 2006 Dutch cardiovascular risk management guidelines, or simvastatin 20\u00a0mg\/day, which was the most frequently prescribed dose up to 2006, versus other statins at various dose levels. Relative risks (<jats:styled-content style=\"fixed-case\">RRs<\/jats:styled-content>) were adjusted for age, sex, year of therapy initiation, cardiovascular disease, type 2 diabetes mellitus, hypertension, baseline low\u2010density lipoprotein cholesterol level, and adherence during the 3\u00a0months before the 12\u2010month follow\u2010up cholesterol measurement. Compared with simvastatin 40\u00a0mg\/day, cholesterol goal attainment rates were significantly higher with atorvastatin 40\u00a0mg\/day (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 1.15, 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] 1.04\u20131.28) and rosuvastatin 10\u00a0mg\/day (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 1.13, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.04\u20131.23), were similar with atorvastatin 20\u00a0mg\/day (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 1.06, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.97\u20131.16) and rosuvastatin 20\u00a0mg\/day (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 1.14, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.93\u20131.39), and were significantly lower with all other frequently used statin dose levels. Compared with simvastatin 20\u00a0mg\/day, cholesterol goal attainment was significantly higher with any dose of atorvastatin and rosuvastatin, but were lower with any dose of pravastatin. Goal attainment rates were similar among patients with lower and higher cardiovascular risk. Among the 13\u201318% of patients who had follow\u2010up cholesterol level measurements at 12 months in all statin groups, the proportion of adherent patients was approximately 75%; this was higher than the proportion of adherent patients in the total population (48\u201355%), which included patients without follow\u2010up cholesterol levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A larger proportion of patients reached cholesterol lipid goals with simvastatin 40 mg\/day. Cholesterol level goals were achieved by many patients using the recommended simvastatin 40 mg\/day, but by fewer patients among those using the more commonly prescribed simvastatin 20 mg\/day. Therefore, especially in high\u2010risk patients, the choice of statin should be based on baseline cholesterol levels and expected reductions in these levels, and treatment should be adapted if targets are not met. Improved cholesterol level monitoring may increase adherence and cholesterol management.<\/jats:p><\/jats:sec>","DOI":"10.1002\/j.1875-9114.2011.01086.x","type":"journal-article","created":{"date-parts":[[2012,9,5]],"date-time":"2012-09-05T03:56:50Z","timestamp":1346817410000},"page":"631-641","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Cholesterol Level Goal Attainment with Statins: Clinical Management Guideline Recommendations versus Management in Actual Clinical Practice"],"prefix":"10.1002","volume":"32","author":[{"given":"Edith M.","family":"Heintjes","sequence":"first","affiliation":[{"name":"PHARMO Institute Utrecht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernie J. A.","family":"Penning\u2010van Beest","sequence":"additional","affiliation":[{"name":"PHARMO Institute Utrecht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arian W.","family":"Plat","sequence":"additional","affiliation":[{"name":"PHARMO Institute Utrecht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Willem Jan","family":"Meerding","sequence":"additional","affiliation":[{"name":"Pfizer BV Capelle aan den IJssel the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"Webb","sequence":"additional","affiliation":[{"name":"Health Economics and Outcomes Research Primary Care Pfizer Ltd Surrey United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam C.","family":"Sturkenboom","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management Erasmus Medical Centre Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ron M. C.","family":"Herings","sequence":"additional","affiliation":[{"name":"PHARMO Institute Utrecht the Netherlands"},{"name":"Department of Health Policy and Management Erasmus Medical Centre Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,7,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61350-5"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2009.02.017"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11883-004-0111-9"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.326.7404.1423"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2006.06.039"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0195-668X(03)00347-6"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehm316"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.1998.1243"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.332.7554.1344"},{"volume-title":"Statins for the prevention of cardiovascular events","year":"2006","author":"National Institute for Health and Clinical Excellence (NICE)","key":"e_1_2_6_11_1"},{"volume-title":"University College London Hospitals Guidelines on statin prescribing in the prevention of cardiovascular disease","year":"2006","author":"Moon J","key":"e_1_2_6_12_1"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2007.02907.x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e3181e41bcb"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1586\/erp.09.43"},{"key":"e_1_2_6_16_1","first-page":"28","article-title":"Beleidsdocument aanwijzing preferente geneesmiddelen [Policy document designating preferential medications]","author":"Zorgverzekeraars N","year":"2005","journal-title":"Staatscourant"},{"issue":"50","key":"e_1_2_6_17_1","first-page":"11","article-title":"Nieuwe voorwaarden cholesterolverlagers [new conditions cholesterol lowering drugs]","volume":"143","author":"Kengetallen SF","year":"2008","journal-title":"Pharmaceutisch Weekblad"},{"key":"e_1_2_6_18_1","unstructured":"CBO\/NHG.Multidisciplinaire richtlijn Cardiovasculair Risicomanagement. Utrecht: Kwaliteitsinstituut voor de gezondheidszorg CBO en Nederlands Huisartsen Genootschap 2006. Report No.: ISBN 10: 90\u20108523\u2010131\u20100; ISBN 13: 978\u201090\u20108523\u2010131\u20108."},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)09327-3"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199811053391902"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)12948-0"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1185\/03007990802264487"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1185\/030079904125004114"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1185\/03007990802203279"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwi188"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.4065\/83.12.1316"},{"issue":"11","key":"e_1_2_6_27_1","first-page":"670","article-title":"The effect of switching on compliance and persistence: the case of statin treatment","volume":"11","author":"Thiebaud P","year":"2005","journal-title":"Am J Manag Care"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-200422003-00003"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2003.026187"},{"key":"e_1_2_6_30_1","first-page":"26","volume-title":"Beoogde besparing op statines is onzeker. Meeste omzettingen blijken niet dosisequipotent [Intended savings on statins are uncertain. Most switches prove not to be to equipotent doses]","author":"van der Vaart R","year":"2009"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10557-005-5686-z"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.4065\/80.9.1163"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2710.2000.00315.x"},{"issue":"9","key":"e_1_2_6_34_1","first-page":"530","article-title":"Overcoming inertia: improvement in achieving target low\u2010density lipoprotein cholesterol","volume":"13","author":"Goldberg KC","year":"2007","journal-title":"Am J Manag Care"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-135-9-200111060-00012"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.294.19.2437"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2008.01.003"},{"key":"e_1_2_6_38_1","first-page":"280","article-title":"Switching statins: the impact on patient outcomes","volume":"14","author":"Phillips JO","year":"2007","journal-title":"Br J Cardiol"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1177\/1074248408331031"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fj.1875-9114.2011.01086.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/j.1875-9114.2011.01086.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T11:42:59Z","timestamp":1761046979000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/j.1875-9114.2011.01086.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,7]]},"references-count":38,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2012,7]]}},"alternative-id":["10.1002\/j.1875-9114.2011.01086.x"],"URL":"https:\/\/doi.org\/10.1002\/j.1875-9114.2011.01086.x","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"type":"print","value":"0277-0008"},{"type":"electronic","value":"1875-9114"}],"subject":[],"published":{"date-parts":[[2012,7]]},"assertion":[{"value":"2012-07-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}