(C-067) COVID-19 Pandemic and Statin Adherence in Sweden: Insights from Cohort Analyses Before and During the Crisis

Background: The COVID-19 pandemic disrupted healthcare provision, potentially affecting medication adherence, particularly among individuals with cardiovascular disease. Given pre-existing issues of poor statin adherence and the potential protective effect of statins in patients with COVID-19, understanding how the pandemic influenced statin use is important.

Objectives: To evaluate the impact of the pandemic on statin adherence by comparing persistence rates before and during the pandemic and identify associated factors.

Methods: Using a historical two-cohort design, we assessed one-year statin persistence in patients initiating therapy in Sweden in July-December 2018 (pre-pandemic cohort, N=80,651) and July-December 2021 (pandemic cohort, N=92,693) with a 6-month washout period (no prior statin prescription). Data were collected from national registers on diagnoses, dispensed prescription drugs, and sociodemographic. Logistic regression estimated odds ratios for being persistent, adjusted for age, gender, country of birth, education, marital status, employment, income, secondary prevention diagnoses, and prior cardiovascular medications.

Results: Statin persistence remained stable (66.4% pre-pandemic and 69.2% during the pandemic). We observed that statin persistence varied across groups, with women, younger individuals, those born abroad, and those with lower incomes exhibiting lower persistence. Higher persistence was linked to older age, higher income, secondary prevention, and prior use of antidiabetics and antihypertensives in both pre-pandemic and pandemic cohorts (p < 0.05). Notably, higher education was associated with lower persistence pre-pandemic but showed no significant association during the pandemic.

Conclusions: Statin persistence remained stable during the pandemic in Sweden, but sociodemographic disparities remained. Strengthening support for vulnerable populations can help maintain adherence during future crises.