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

## TL;DR

A counseling service in pharmacies helps patients stick to their statin medication for a year, improving heart health outcomes.

## Contribution

This study shows that pharmacy-based counseling increases statin persistence in patients through a nationwide cohort analysis.

## Key findings

- Patients receiving counseling had 80.2% one-year persistence compared to 73.6% in controls.
- Adjusted odds ratios showed a 43% higher likelihood of persistence after the intervention.
- Register data provided robust evidence for improved statin adherence.

## Abstract

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.

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.

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).

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.

•A motivating counseling service in community pharmacies improves statin adherence.•Targeting low-persistence groups can yield even greater intervention effects.•Robust register data strengthens valid results on one-year statin persistence rates.

A motivating counseling service in community pharmacies improves statin adherence.

Targeting low-persistence groups can yield even greater intervention effects.

Robust register data strengthens valid results on one-year statin persistence rates.