To assess the patterns of use of ASA-statin free combinations in primary care: a population-based study in Italy

Endocrine. 2025 Sep 30. doi: 10.1007/s12020-025-04373-x. Online ahead of print.

ABSTRACT

PURPOSE: Cardiovascular events like heart attacks and strokes can be effectively prevented by ASA (acetylsalicylic acid) and statins. Research indicates that ASA-statins-fixed combinations benefit both primary and secondary cardiovascular event prevention. The primary advantage is enhancing and maintaining medication adherence, a significant concern in cardiovascular disease treatment. We evaluated users of free ASA-statin combinations to quantify adherence levels and identify characteristics of adherent patients.

MATERIALS AND METHODS: We formed a cohort of individuals 18 years or older active in a primary care database on December 31, 2022, and prescribed both ASA and statins that year.

RESULTS: Of prevalent and incidence users of ASA-statin therapy, only 31 and 21% were properly adherent, respectively. Higher adherence rates were observed in males (11% more), those with cerebro/cardiovascular diseases (13% more), and patients taking 5 or more concurrent medications (45% more). Conversely, patients with gastrointestinal disorders, heart failure, atrial fibrillation, depression, or asthma/COPD showed significantly lower adherence. Most adherent patients (63-82%) used low-dose statins with ASA.

CONCLUSIONS: The findings suggest that adherence among patients using free-ASA-statin combinations is suboptimal. Given the importance of improving medication adherence, it is essential for primary care physicians to devise and implement strategies to enhance and sustain medication adherence, particularly for patients with specific characteristics.

PMID:41026388 | DOI:10.1007/s12020-025-04373-x