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<p>Statin optimization in older adults is increasingly relevant within the geroscience framework of cardiovascular ageing. This randomized controlled trial evaluated whether pharmacist-led pharmaceutical care improves lipid outcomes and statin adherence in community-dwelling older adults receiving primary care. A total of 99 patients aged 65&#xa0;years or older on long-term statin therapy were randomized to usual care or structured pharmacist-led care delivered every 3 months. The primary outcome was change in low-density lipoprotein cholesterol at 6&#xa0;months. Secondary outcomes included changes in other lipid parameters and dispensing-based adherence assessed by the proportion of days covered. The present analysis represents a pre-specified interim evaluation and was conducted on a per-protocol population with complete 6-month laboratory data. No statistically significant between-group difference in low-density lipoprotein cholesterol reduction was observed (adjusted difference −0.129&#xa0;mmol/L, <i>p</i> = 0.385). Statin adherence was high and stable in both groups throughout follow-up, with 84–87% of patients meeting adherence thresholds and approximately 75–77% achieving perfect dispensing, consistent with an apparent ceiling effect. Exploratory sex-stratified analyses identified potential differences in lipid responses, but these were not statistically robust. In these highly adherent elderly populations, pharmacist-led pharmaceutical care was not associated with additional short-term improvement in LDL-C or dispensing-based adherence. The findings highlight the importance of baseline adherence when evaluating adherence-focused interventions in older adults.</p> Graphical abstract <p></p>

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Statin therapy optimization in older adults: interim results of a randomized controlled trial of pharmacist-led pharmaceutical care

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月29日

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  • Anna Artner,
  • Ágnes Szélvári,
  • Ilona Oláh,
  • Irén Ballya,
  • Balázs Hankó,
  • Romána Zelkó,
  • Péter Torzsa

摘要

Statin optimization in older adults is increasingly relevant within the geroscience framework of cardiovascular ageing. This randomized controlled trial evaluated whether pharmacist-led pharmaceutical care improves lipid outcomes and statin adherence in community-dwelling older adults receiving primary care. A total of 99 patients aged 65 years or older on long-term statin therapy were randomized to usual care or structured pharmacist-led care delivered every 3 months. The primary outcome was change in low-density lipoprotein cholesterol at 6 months. Secondary outcomes included changes in other lipid parameters and dispensing-based adherence assessed by the proportion of days covered. The present analysis represents a pre-specified interim evaluation and was conducted on a per-protocol population with complete 6-month laboratory data. No statistically significant between-group difference in low-density lipoprotein cholesterol reduction was observed (adjusted difference −0.129 mmol/L, p = 0.385). Statin adherence was high and stable in both groups throughout follow-up, with 84–87% of patients meeting adherence thresholds and approximately 75–77% achieving perfect dispensing, consistent with an apparent ceiling effect. Exploratory sex-stratified analyses identified potential differences in lipid responses, but these were not statistically robust. In these highly adherent elderly populations, pharmacist-led pharmaceutical care was not associated with additional short-term improvement in LDL-C or dispensing-based adherence. The findings highlight the importance of baseline adherence when evaluating adherence-focused interventions in older adults.

Graphical abstract