Cardiovascular medication use for the primary and secondary prevention of cardiovascular disease in the UK: trends, determinants and lifestyle behaviours.
Principal Investigator: Ms Inna Thalmann
Approved Research ID: 41437
Approval date: September 3rd 2018
AIMS The aims of this DPhil research are threefold. First, the study aims to analyse the situation in the UK by estimating the degree of suboptimal cardiovascular medication use for the primary and secondary prevention of cardiovascular disease (CVD) and to examine variations in the uptake of interventions, such as cholesterol- and blood-pressure-lowering drugs, across socio-economic groups. Secondly, the DPhil study aims to investigate the role of patient characteristics in the underutilisation of cardiovascular medications by studying their relevance to the use of cardioprotective medications among patients with (a) a history of CVD-related events, procedures and operations and (b) individuals at high risk of CVD. The study also aims to examine associations between non-adherence to cardiovascular medications for the secondary prevention of CVD and subsequent adverse cardiovascular events. Third, the DPhil study aims to investigate lifestyle patterns and clustering of lifestyle behaviours of individuals with a history of CVD or at high risk of CVD, who use cardiovascular medications for the primary or secondary prevention of CVD, compared to those who do not. SCIENTIFIC RATIONALE Although there is substantial evidence on the cost-effectiveness of cardiovascular medications such as cholesterol- and blood pressure-lowering drugs in reducing risks of cardiovascular disease (CVD), preventive drug use and compliance rates remain largely suboptimal in the UK and Europe. However, knowledge regarding the underlying reasons for the suboptimal drug use and variations in the uptake of interventions across socio-economic groups, as well as adherence to clinical guidance on lifestyle modifications during medication use are limited. Building on the gaps in literature, this DPhil thesis aims to use UK Biobank data to provide new insights into important patient characteristics that are needed to understand the underlying reasons for the suboptimal cardiovascular medication use and variations across socio-economic groups, as well as behavioural lifestyle patterns of medication users. PROJECT DURATION The project will take place from April 2018 until April 2021, i.e. 36 months. Access to data will be required for an additional 24 months after completion of the project. PUBLIC HEALTH IMPACT Addressing the present challenges of CVD prevention is essential to improving the management of disease and to decreasing the high burden and associated costs of CVD, which is a leading cause of mortality worldwide. The findings will support novel effective policies for treatment amelioration and lifestyle management that are urgently needed given the high burden and costs of cardiovascular disease.