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CATHERINE E. COOKE, PHARM.D., BCPS, PAHM, is Clinical Education Consultant, Pfizer U.S. Pharmaceuticals, Ellicott City, MD, and Clinical Assistant Professor, Department of Pharmacy Practice and Science (DPPS), School of Pharmacy, University of Maryland (UM), Baltimore. CAPT JAMES L. BRESETTE, PHARM.D., U.S. Public Health Service, is Deputy Director, Office of Clinical and Preventive Services, Indian Health Service Headquarters, Rockville, MD. ROZINA KHANNA, PHARM.D., is Manager, Virology Medical Strategy, Bristol-Myers Squibb, Plainsboro, NJ, and at the time of the study was a pharmacy student, School of Pharmacy, UM.

Address correspondence to Dr. Cooke at 5106 Bonnie Branch Road, Ellicott City, MD 21043 (cecooke1{at}hotmail.com).

Purpose. The use and adherence to statin therapy in American Indians and Alaska Natives with coronary artery disease (CAD) were studied. Methods. A retrospective database analysis of the Phoenix Area of the Indian Health Service was conducted. For the cohort of patients with CAD, prescription data were obtained for all statins during calendar year 2003. Use was determined by the presence of at least one statin prescription, whereas adherence was assessed using the medication possession ratio (MPR), persistence, and median gap. Results. The study cohort was composed of 2095 adults (55.6% men) with at least one medical encounter for CAD during calendar year 2002. The mean ± S.D. age of the cohort was 62.7 ± 12.7 years. At least one prescription for any statin drug during 2003 was found for 865 (41.3%) patients. Those who received a statin were more likely to be male, be younger than 80 years, and have a greater number of medical visits. The mean MPR was 0.78 ± 0.25, and nonadherence was found in approximately 40% of patients receiving statins. In the age category of 65–79 years, men were more adherent than women, and patients in this category were overall more adherent than younger patients. Conclusion. The use of statins in a cohort of American Indians and Alaska Natives at high risk for cardiovascular events was approximately 40% with a 60% adherence rate. Age, sex, and number of medical visits were associated with statin use, and age and sex were associated with adherence. Index terms: Age; Antilipemic agents; Compliance; Coronary disease; Drug use; Ethnic groups; Patients; Sex