Barrett A, DiBenedetti DB, Rane P, Wade S, Qian Y. Assessing attitudes and treatment preferences among patients with hyperlipidemia: patient focus groups. Poster presented at the AHA QCOR 2017 Scientific Sessions; April 2, 2017. Arlington, VA. [abstract] Circ Cardiovasc Qual Outcomes. 2017 Mar; 10(Suppl 3):A022.

OBJECTIVE: To better understand current and recent statin users’ perceptions, attitudes, experiences, and preferences related to hyperlipidemia (HLD) and its treatment.

METHODS: Four focus groups were conducted in 2 cities in the US with individuals (N = 28) ≥ 18 years old self-reporting a clinician diagnosis of HLD for ≥ 6 months and current or previous statin use for ≥ 3 months in the past year. Two of the focus groups included a total of 13 participants reporting a cardiovascular event or surgery (e.g., heart attack, stroke, stent placement) in the past 10 years (CV group). The other two groups included a total of 15 participants who had not had a CV event or surgery (non-CV group). Concern about HLD and treatment motivation, adherence, and preferences were explored.

RESULTS: Among the 28 participants, 15 (53.6%) were male. The mean age was 57.3 ± 10.1 years. At screening, 6 (21.4%) participants were not using a statin, and 3 of these 6 reported statin intolerance. The majority of the 28 participants (17; 60.7%) had switched statins. Including their current statin, 10 (35.7%) participants had used 2 statins, and 7 (25.0%) had used 3 statins. Twelve (42.9%) participants had experienced statin-related muscle aches. Participants reported high levels of statin adherence, but reasons for dissatisfaction were noted: adverse events (primarily muscle aches and gastrointestinal symptoms), insufficient lowering of cholesterol levels, and worry about potential liver damage with long-term use. All participants identified having no/few side effects, lowering cholesterol levels, and preventing CV events as important attributes of cholesterol-lowering drugs (CLDs). Avoidance of drug-drug interactions was important for all 13 CV group participants but for only 4 of the 15 (26.7%) non-CV group participants. Although participants believed statins reduced cholesterol levels, they generally considered lifestyle changes, such as eating a healthy diet and exercising, to be more or as effective. Overall, 60.7% (17 of 28) said they would be willing to try an injectable CLD in addition to their current treatment if cholesterol levels were not sufficiently lowered. Given the choice of a prefilled syringe, autoinjector, or on-body infusor (with no limit on the number of selections), the autoinjector was acceptable to the largest percentage of participants (22 of 28; 78.6%), followed by the on-body infusor (13 of 28; 46.4%). More participants in the CV group than the non-CV group were willing to try each type of injection.

DISCUSSION: The frequent switching and side effects highlight significant unmet need in patients with HLD and dissatisfaction with statins among current and recent users, with and without a history of CV events. Results also suggest that a sizeable portion of patients with HLD may be willing to try an injectable CLD.

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