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The National Cholesterol Education Program (NCEP) guidelines recommend monitoring blood cholesterol concentrations to assess and promote patient adherence to cholesterol-lowering drug treatment. How well such monitoring actually identifies nonadherence, however, is unknown. In this secondary analysis of pravastatin trial data, investigators assessed the accuracy of monitoring cholesterol concentration for detecting nonadherence.
More than 9000 patients with coronary heart disease were randomized to receive daily pravastatin (40 mg) or placebo. Patients who reported taking any of their pills were defined as “adherent,” whereas those who stopped taking their pills were defined as “nonadherent.” After 1 year, 6% of “adherent” patients and 50% o…