Dietary, Physical Activity and Other Lifestyle Habits and their Associations with Medication Adherence in a Group of Hypercholesterolemic Patients Prescribed Statin Therapy in Kuwait

Abstract

The growing epidemic of coronary heart disease (CHD) is evident worldwide, accounting for global mortality rates of approximately 7.2 million per year. Coronary heart disease causes are multi-factorial encompassing both intrinsic and extrinsic factors; including age, gender, genetics, diet, physical activity, obesity, psychology, smoking and alcohol intake. Serum low density lipoprotein (LDL), an underlying consequence mainly of poor dietary habits, is strongly associated with increased risk of developing CHD and therefore a major target for CHD risk reduction strategies. Although intrinsic factors such as age, gender and genetics cannot be controlled or corrected, modifiable factors (extrinsic) can be managed and thus CHD risk may be reduced. Prescription of lipid-lowering drugs such as statins (3-hydroxy-3-methyl-glutaryl-CoA reductase or HMG-CoA inhibitors) has significantly increased due to their LDL-cholesterol lowering properties, where subsequently CHD risk may be reduced. There is little doubt in the efficacy of these drugs; the effectiveness however, is the issue in question. Various studies have reported up to 55% non-adherence to statin medications, after 6 months of treatment. It is important to recognize that once statin adherence subsides in these patients, risk reduction is dependent on the alternative concomitant therapies (diet, physical activity, maintenance of weight and smoking cessation), which may or may not have been implemented by the patient. Therefore the goal of this study was investigate the degree of adherence to statin medication, and alternative concomitant behaviours and examine whether an association exists between these various coronary risk reduction factors and overall CHD risk profile.Thesis (PhD Doctorate)Doctor of Philosophy (PhD)School of Public HealthGriffith HealthFull Tex