Persistence to statin treatment: A cohort study in Lithuania.

Cardiovascular diseases are the main causes of death, and statins can reduce the risk of major vascular events. Lithuania is among the European countries with the highest cardiovascular mortality despite a rapidly increasing use of statins. Previous reviews have shown the problem of poor patient adherence, but there are limited studies from Eastern European countries. The aim of this study was to evaluate treatment persistence in new users of statins in Lithuania and to investigate factors associated with persistence. Dispensed prescriptions from patients aged >18 years old initiated on statins in 2018-2019 were included, and data were obtained from a national health insurance fund. Persistence was assessed by the proportion of patients who still had statins dispensed 1 year after the first dispensing. Factors associated with persistence were assessed using logistic regression. A total of 104 726 patients (41.3% men) were initiated on statin treatment. Only 41% of them continued statin use 1 year after initiation. Factors associated with higher persistence rate were older age, higher dose of statin, use of other medicines and use of statins as secondary prevention. Low persistence to statin therapy needs to be recognized by healthcare workers, pharmacists and policy makers to address this problem.

Sodium, Potassium and Iodine Intake in an Adult Population of Lithuania.

Hypertension is a leading risk factor for cardiovascular events and death. A reduction in salt intake is among the most cost-effective strategies to reduce blood pressure and the risk of cardiovascular diseases. Increasing potassium lowers blood pressure and is associated with lower cardiovascular risk. Adequate iodine intake is important to prevent iodine deficiency disorders. Salt iodization is a key strategy to prevent such deficiency. In Lithuania, no surveys have been performed to directly assess sodium, potassium and iodine consumption. The aim of the present study was to measure sodium, potassium and iodine intake in a randomly selected adult Lithuanian adult population using 24 h urine collections, and to assess knowledge, attitudes and behavior towards salt consumption. Salt and potassium intakes were estimated in 888 randomly selected participants by 24 h urine sodium and potassium excretion and 679 individuals provided suitable 24 h urine samples for the analysis of iodine excretion. Average salt intake was 10.0 (SD 5.3) g/24 h and average potassium intake was 3.3 (SD 1.3) g/24 h. Only 12.5% of participants consumed less than 5 g/24 h of salt. The median value of urinary iodine concentration (UIC) was 95.5 µg/L. Our study showed that average salt intake is twice as high as the maximum level recommended by the World Health Organization while potassium and iodine intakes in Lithuania are below the recommended levels.

Non-persistence to antihypertensive drug therapy in Lithuania.

PURPOSE: Poor persistence to antihypertensive therapy is an important cause of treatment failure. Investigating persistence is especially important in countries with a high cardiovascular mortality, like Lithuania. The aim of this study was to describe the antihypertensive treatment at initiation, to determine the percentage of patients not being persistent with antihypertensive treatment after 1 year and to explore factors associated with non-persistence. METHODS: In this cohort study, data on dispensed prescription medicines from the Lithuanian National Health Insurance Fund (NHIF) were used. All adult patients with a diagnosis of hypertension having first antihypertensive dispensed in 2018 were included. Descriptive statistics was used to determine the number of patients started with monotherapy and combination therapy. Treatment choice by Anatomical Therapeutic Chemical (ATC) and number of active pharmaceutical ingredient (API) was described. Non-persistence was assessed using the anniversary method. Multivariate logistic regression was used to explore factors associated with non-persistence. RESULTS: A total of 72,088 patients were included into the study, 56% started on monotherapy treatment, with 49% being dispensed an angiotensin converting enzyme inhibitor, and 44% started on combination therapy. Overall, 57% of patients were non-persistent after 1 year. Patients' gender and prescriber qualification showed no association with non-persistence. Younger patients, patients from rural area, patients started with monotherapy, and patients with no medication change had higher odds to become non-persistent. CONCLUSIONS: The majority of patients were initiated with treatment following hypertension management guidelines, but it is of concern that over half of the patients were non-persistent to antihypertensive therapy in the first year.

Prevalence of tick-borne encephalitis virus in questing Dermacentor reticulatus and Ixodes ricinus ticks in Lithuania.

The Baltic States are the region in Europe where tick-borne encephalitis (TBE) is most endemic, with one-third of the European TBE cases detected in Lithuania, Latvia and Estonia. With the Czech Republic and Germany, Lithuania has among the highest population incidences of TBE. Ticks from the Ixodidae family are the main vectors of the TBE virus (TBEV) in Europe. However, there is still a lack of data on the prevalence of TBEV in ticks in different parts of Lithuania. This study analysed the current prevalence of TBEV in the two most common tick species distributed in Lithuania: Ixodes ricinus and Dermacentor reticulatus. Questing I. ricinus (n = 7170) and D. reticulatus (n = 1676) ticks were collected from 81 locations in all ten counties of Lithuania between 2017 and 2019. The presence of TBEV was analysed using a real-time reverse transcription polymerase chain reaction (RT-PCR) and TBEV prevalence in ticks was calculated as the minimum infection rate (MIR). TBEV was detected in the three developmental stages (adults, nymphs and larvae) of I. ricinus and in D. reticulatus adults. The MIR of TBEV in the total sample of I. ricinus was 0.4 % (28/7170) and for D. reticulatus was also estimated to be 0.4 % (6/1676). TBEV-infected ticks were found in 16 locations in seven counties, with MIR ranging from 0.1 % to 1.0 %. The TBEV strains detected belong to the European subtype. To the best of the authors' knowledge, this is the first report on the prevalence of TBEV in unfed D. reticulatus ticks and in I. ricinus unfed larvae in Lithuania.