Improved persistence to statin therapy through a patient counseling intervention in community pharmacies - A nationwide cohort study.

Background: Poor adherence is a well-known problem for statins, key medicines for reducing cardiovascular morbidity and mortality. Community pharmacy services have been identified as a way to increase adherence. We assessed the effect of motivating counseling in Swedish community pharmacies on treatment persistence in patients starting statin therapy. Methods: In this cohort study, one-year persistence was evaluated in patients who initiated statin therapy (ATC C10AA) between October 2022 and June 2023 following pharmacy-based counseling, and compared with five age- and sex-matched controls per patient from pharmacies not providing the service. Data were collected from Swedish national health registers on dispensed medications, diagnoses and socioeconomic characteristics of patients. Odds ratios for being persistent with 95 % confidence intervals were calculated using a logistic regression model adjusted for socioeconomics, cardiovascular comorbidity and pharmacy size. Results: A total of 902 patients who had data available in the Swedish national registers received the intervention. They had a higher education and income, mostly Swedish born and they had less history of cardiovascular disease, compared to the 4510 age- and sex-matched controls. The one-year persistence was significantly higher among those who received the service compared to controls (80.2 % compared to 73.6 %). Adjusted odds ratios for being persistent after the intervention was 1.43 (95 % CI 1.19-1.71). Conclusion: Patients who receive a motivating counseling service in community pharmacies have a higher persistence to statin treatment, one year after initiation, after adjustment for differences in patient characteristics.