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The COVID-19 Pandemic Did Not Negatively Impact Adherence to Cardiovascular Medications Among 548,601 Chronically
Finlay A McAlister1, Anamaria Savu1, Luan Manh Chu1,2
1Canadian Vigour Centre, Katz Group Centre for Pharmacy and Health Research, University of Alberta College of Health Sciences, Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada.
Insights
COVID-19 pandemic adherence to cardiovascular drugs improved. Patients taking chronic cardiovascular medications showed better adherence during the pandemic compared to before, contrary to initial concerns.
Area of Science:
- Cardiology
- Public Health
- Pharmacology
Background:
- COVID-19 pandemic's potential negative impact on chronic medication adherence was a concern.
- Previous studies suggested decreased patient adherence during the pandemic.
Purpose of the Study:
- To investigate changes in adherence patterns for cardiovascular drugs during the COVID-19 pandemic.
- To compare adherence rates before and after the pandemic's onset in chronic cardiovascular drug users.
Main Methods:
- Retrospective cohort study analyzing drug dispensation data from adult Albertans (2017-2023).
- Calculated Proportion of Days Covered (PDC) for cardiovascular drugs in prepandemic and pandemic phases.
- Used logistic regression to assess adherence changes, adjusting for demographic and clinical factors.
Main Results:
- Over 548,000 chronic users of cardiovascular drugs were analyzed.
- Good adherence (PDC >0.8) increased from 72.8% to 75.4% during the pandemic.
- Adjusted odds ratios indicated improved adherence for various cardiovascular drug classes, notably statins (aOR 1.16).
Conclusions:
- Chronic users of cardiovascular drugs demonstrated improved adherence during the COVID-19 pandemic.
- The pandemic period was associated with better medication adherence for cardiovascular conditions.
Background:
Studies have suggested that the COVID-19 pandemic negatively impacted patient adherence with chronic medications. We explored whether adherence patterns changed in patients chronically treated with cardiovascular drugs after onset of the COVID-19 pandemic.
Methods:
In this retrospective cohort study we examined drug dispensation data for all adult Albertans who were chronic users of at least 1 cardiovascular drug class between 2017 and 2023. We calculated each patient's proportion of days covered (PDC) for each drug class in the prepandemic phase (March 15, 2018 to March 14, 2020) and the pandemic phase (March 15, 2020 to March 14, 2022), and used generalized estimating equation logistic regression to estimate the effect of time period on achievement of good adherence (PDC >0.8) after adjusting for age, sex, socioeconomic status, and comorbidities.
Results:
Of 548,601 chronic users of at least 1 cardiovascular drug class between March 15, 2018 and March 14, 2022, 47.2% were women, the mean age was 62.3 years, and 55.4% had Charlson Comorbidity Index (CCI) scores of 0. The most frequently dispensed cardiovascular drugs were angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (67.6%) and statins (53.8%); the most frequent diagnoses were hypertension (77.2%), diabetes mellitus (30.6%), and ischemic heart disease (19.6%). Chronic users of cardiovascular drugs were more likely to have PDC >0.8 during the pandemic than in the prepandemic period: 75.4% vs 72.8%, with adjusted odds ratios ranging from 1.05 (95% confidence interval 1.00-1.11) for mineralocorticoid receptor antagonists to 1.16 (95% confidence interval 1.15-1.17) for statins.
Conclusions:
Chronic users of cardiovascular drugs exhibited better adherence during the COVID-19 pandemic than before the pandemic.
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