Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

The Healthy Adherer Effect—Reply

The Healthy Adherer Effect—Reply In reply We thank the authors of the letter for their comments. Andersohn and Willich noted some methodological concerns with our analysis, particularly the potential “healthy adherer” bias. A recent study1 aimed to examine whether adherence with statin use is associated with a decreased risk of unintentional injuries that were sought to be unrelated to statins (eg, motor vehicle crashes and workplace injuries, burns, and falls). As expected, they found a modest (10%-15%) overall reduction in the rate of unintentional injuries among adherent patients compared with nonadherent ones. Thus, the “healthy adherer” bias could explain some of our results, but clearly not a 45% reduction in all-cause mortality. We agree with the authors that the reduction in all-cause mortality cannot be explained only by a decrease in cardiovascular diseases mortality, but probably by reducing mortality from other diseases due to the pleiotropic effects of statins. The authors also speculate that nonadherent patients were more likely to have serious medical conditions and therefore demonstrate higher mortality rates. However, our previous analysis2 clearly indicates that nonadherent patients are younger and less likely to have chronic conditions. Correspondence: Dr Chodick, Medical Informatics, Maccabi Healthcare Services, HaMered 27, Tel Aviv 63299, Israel (hodik_g@mac.org.il). References 1. Dormuth CRPatrick ARShrank WH et al. Statin adherence and risk of accidents: a cautionary tale. Circulation 2009;119 (15) 2051- 2057PubMedGoogle ScholarCrossref 2. Chodick GShalev VGerber Y et al. Long-term persistence with statin treatment in a not-for-profit health maintenance organization: a population-based retrospective cohort study in Israel. Clin Ther 2008;30 (11) 2167- 2179PubMedGoogle ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

The Healthy Adherer Effect—Reply

Shalev, Varda; Chodick, Gabriel
Archives of Internal Medicine , Volume 169 (17) – Sep 28, 2009
Download PDF
2 pages

Loading next page...
 
/lp/american-medical-association/the-healthy-adherer-effect-reply-95GOMUtSZp

References (2)

Publisher
American Medical Association
Copyright
Copyright © 2009 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinternmed.2009.325
Publisher site
See Article on Publisher Site

Abstract

In reply We thank the authors of the letter for their comments. Andersohn and Willich noted some methodological concerns with our analysis, particularly the potential “healthy adherer” bias. A recent study1 aimed to examine whether adherence with statin use is associated with a decreased risk of unintentional injuries that were sought to be unrelated to statins (eg, motor vehicle crashes and workplace injuries, burns, and falls). As expected, they found a modest (10%-15%) overall reduction in the rate of unintentional injuries among adherent patients compared with nonadherent ones. Thus, the “healthy adherer” bias could explain some of our results, but clearly not a 45% reduction in all-cause mortality. We agree with the authors that the reduction in all-cause mortality cannot be explained only by a decrease in cardiovascular diseases mortality, but probably by reducing mortality from other diseases due to the pleiotropic effects of statins. The authors also speculate that nonadherent patients were more likely to have serious medical conditions and therefore demonstrate higher mortality rates. However, our previous analysis2 clearly indicates that nonadherent patients are younger and less likely to have chronic conditions. Correspondence: Dr Chodick, Medical Informatics, Maccabi Healthcare Services, HaMered 27, Tel Aviv 63299, Israel (hodik_g@mac.org.il). References 1. Dormuth CRPatrick ARShrank WH et al. Statin adherence and risk of accidents: a cautionary tale. Circulation 2009;119 (15) 2051- 2057PubMedGoogle ScholarCrossref 2. Chodick GShalev VGerber Y et al. Long-term persistence with statin treatment in a not-for-profit health maintenance organization: a population-based retrospective cohort study in Israel. Clin Ther 2008;30 (11) 2167- 2179PubMedGoogle ScholarCrossref

Journal

Archives of Internal Medicine – American Medical Association

Published: Sep 28, 2009

Keywords: burns,chronic disease,statins,cardiovascular diseases,israel,medical informatics,traffic accidents

There are no references for this article.