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J Occup Health year 2002 volume 44 number 5 page 307 - 314
Classification Original
Title Acceptability and Long-Term Compliance with Drug Treatment for Hypercholesterolemia in Japanese Male Workers:
II. Long-Term Compliance with Drug Treatment
Author Masayuki TATEMICHI1, Tsutahiro HAMAGUCHI2, Munetaka HASHIRA3, Takeshi HAYASHI4, Masato ITO5, Atsushi NAKATANI4, Hisanori HIRO6, Koji MORI7, Yasushi OKUBO8, Takafumi EZAKI9, Hiroki SUGIMORI10 and Katsumi YOSHIDA10 (S-LIT Study Group)
Organization 1Department of Environmental and Occupational Health, Toho University School of Medicine, 2IBM Japan Medical Services, 3Health Management Division of Aizuwakamatsu Factory, Fujitsu Corp., 4Hitachi Health Care Center, 5Health Management Division of Matsushita Electronics Corp., 6Center for Occupational Health, Tsurumi, NKK., 7Medicine & Occupational Health, Exxon Mobil Business Services Private Ltd., 8Department of Occupational and Environmental Medicine Chiba University School of Medicine, 9Kyoto Industrial Health Association and 10Department of Preventive Medicine, St. Marianna University School of Medicine, Japan
Keywords Long term, Compliance, Hyper-cholesterolemia, Male workers, Drug treatment
Correspondence M. Tatemichi, Department of Environmental and Occupational Health, Toho University School of Medicine, 5-21-16 Omori-nishi, Otaku, Tokyo 143-8540, Japan
Abstract Acceptability and Long-Term Compliance with Drug Treatment for Hypercholesterolemia in Japanese Male Workers: II. Long-Term Compliance with Drug Treatment: Masayuki TATEMICHI, et al. Department of Environmental and Occupational Health, Toho University School of Medicine-We undertook a prospective study to assess the long-term compliance of Japanese male workers with drug treatment for hypercholesterolemia. In workers who accepted treatment with simvastatin, an HMG-CoA reductase inhibitor, compliance was monitored every 6 months with an interview. Factors affecting compliance were identified by using the background characteristics of subjects and a self-administered questionnaire on their type of job, job style, private lifestyle and psychological status at work. Mean (SD) follow-up periods were 21.5 (10.6) months for 640 workers, and 240 noncompliant (< 75 % of prescription) subjects were found. Of these 240, 23 (9.6%) were restored to be finally compliant at the last follow-up (re-compliant). We assessed the time-course rate of compliant subjects and factors affecting drug compliance using Cox proportional hazard model by setting occurrence of a noncompliant attitude to an endpoint. The cumulative compliance rate at 36 months was 0.508 when excluding 23 re-compliant subjects and 0.529 when considering them as compliant. Multivariate analysis showed that age and present medical illness with hypertension (HT) in background characteristics of subjects and the habit of having breakfast daily in factors related to private-lifestyle were significantly associated with compliance. Baseline lipid profiles and work related issues were not associated with compliance. The occurrence rate of side effects did was similar in compliant and noncompliant workers. In this study, even though considering the re-compliant subjects, the rate of compliant subjects over a 3-yr period was considerably low (around 50%). The factors related to compliance were age, present illness with HT and the habit of having breakfast daily.