{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:04:27Z","timestamp":1792785867113,"version":"4.5.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Skaraborg Institute for Research and Development","award":["23\/1034"],"award-info":[{"award-number":["23\/1034"]}],"id":[{"id":"https:\/\/ror.org\/00691gs61","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Local Research and Development Council","award":["RHS 2024-01268"],"award-info":[{"award-number":["RHS 2024-01268"]}]},{"name":"Emelle Foundation for Research on Cardiovascular Diseases"},{"name":"Swedish government"},{"DOI":"10.13039\/501100001034","name":"ALF","doi-asserted-by":"publisher","award":["ALFGBG-965452"],"award-info":[{"award-number":["ALFGBG-965452"]}],"id":[{"id":"10.13039\/501100001034","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001034","name":"ALF","doi-asserted-by":"publisher","award":["ALFGBG-1005368"],"award-info":[{"award-number":["ALFGBG-1005368"]}],"id":[{"id":"10.13039\/501100001034","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001034","name":"ALF","doi-asserted-by":"publisher","award":["ALFGBG-1016002"],"award-info":[{"award-number":["ALFGBG-1016002"]}],"id":[{"id":"10.13039\/501100001034","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001034","name":"ALF","doi-asserted-by":"publisher","award":["ALFGBG-1016439"],"award-info":[{"award-number":["ALFGBG-1016439"]}],"id":[{"id":"10.13039\/501100001034","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Swedish government"},{"name":"Swedish government"},{"name":"Gothenburg Society of Medicine","award":["GLS-1022271"],"award-info":[{"award-number":["GLS-1022271"]}]},{"DOI":"10.13039\/501100007687","name":"Swedish Society of Medicine","doi-asserted-by":"publisher","award":["SLS-1016912"],"award-info":[{"award-number":["SLS-1016912"]}],"id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007687","name":"Swedish Society of Medicine","doi-asserted-by":"publisher","award":["SLS-1021476"],"award-info":[{"award-number":["SLS-1021476"]}],"id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Swedish government"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Evidence regarding statin adherence among patients with hypertension in primary care is limited. We assessed statin adherence in Swedish primary care and examined associations between patient characteristics and adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In this retrospective register-based cohort study from a large Swedish region, data from all primary health care centres were linked to data on comorbidities, dispensed drugs, and socioeconomic factors. Patients with hypertension who initiated statin therapy in 2012\u20132015 were included. Adherence during 2 years after initiation was measured using the proportion of days covered (PDC). Explainable machine learning with XGBoost and SHAP values identified baseline characteristics associated with adherence. Associations were estimated using adjusted multilevel regression and presented as odds ratios (ORs) and median odds ratios (MORs). Among 30 497 patients (mean age 66 years; 48% women), the mean 2-year PDC was 73.2%, while 60.2% achieved adequate adherence (PDC &amp;gt; 80%). Adequate adherence differed by indication (P &amp;lt; 0.001): 54.0% in primary prevention, 61.3% in diabetes without cardiovascular disease, and 65.5% in secondary prevention. The five most important characteristics associated with adequate adherence according to SHAP values were dispensed antithrombotic therapy (OR 1.38, 95% CI 1.26\u20131.50), primary health care centre (MOR 1.16, 95% CI 1.12\u20131.20), 10-year increase in age (OR 1.14, 95% CI 1.12\u20131.17), initiation with atorvastatin (OR 1.33, 95% CI 1.24\u20131.44), and countries of birth outside Sweden (OR range 0.73\u20130.78).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Only 60% of patients achieved adequate statin adherence, which varied substantially by indication. Patient- and provider-level factors identified could guide targeted interventions to optimize preventive cardiovascular care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcvp\/pvag048","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T05:28:46Z","timestamp":1782710926000},"page":"458-467","source":"Crossref","is-referenced-by-count":2,"title":["Statin adherence among patients with hypertension in Swedish primary health care: a QregPV cohort study using explainable machine learning"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2509-9294","authenticated-orcid":false,"given":"Johan","family":"Sandsl\u00e4tt","sequence":"first","affiliation":[{"name":"N\u00e4rh\u00e4lsan Kroksl\u00e4tt Health Care Centre , Fred\u00e5sgatan 13, 431 67 Gothenburg ,","place":["Sweden"]},{"name":"General Practice\/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , 405 30 Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0757-5774","authenticated-orcid":false,"given":"Kristina","family":"Bengtsson Bostr\u00f6m","sequence":"additional","affiliation":[{"name":"General Practice\/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , 405 30 Gothenburg ,","place":["Sweden"]},{"name":"Regionh\u00e4lsan R&D Centre, Skaraborg Primary Care , 541 80 Sk\u00f6vde ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1459-6661","authenticated-orcid":false,"given":"Maria","family":"\u00c5berg","sequence":"additional","affiliation":[{"name":"General Practice\/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , 405 30 Gothenburg ,","place":["Sweden"]},{"name":"Region V\u00e4stra G\u00f6taland, Regionh\u00e4lsan , 405 30 Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7771-7216","authenticated-orcid":false,"given":"Johan-Emil","family":"Bager","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Sahlgrenska University Hospital , 413 46 Gothenburg ,","place":["Sweden"]},{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , 413 45 Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8120-5566","authenticated-orcid":false,"given":"Koen","family":"Simons","sequence":"additional","affiliation":[{"name":"Biostatistics, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , 405 30 Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0147-8746","authenticated-orcid":false,"given":"Georgios","family":"Mourtzinis","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , 413 45 Gothenburg ,","place":["Sweden"]},{"name":"Department of Medicine and Emergency Care Mo\u0308lndal, Sahlgrenska University Hospital , 431 80 M\u00f6lndal ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0725-5918","authenticated-orcid":false,"given":"Per","family":"Hjerpe","sequence":"additional","affiliation":[{"name":"General Practice\/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , 405 30 Gothenburg ,","place":["Sweden"]},{"name":"Regionh\u00e4lsan R&D Centre, 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