在艾伯塔省548601名慢性治疗患者中，COVID-19大流行并未对心血管药物的依从性产生负面影响

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

CJC Open Pub Date : 2025-02-01 DOI:10.1016/j.cjco.2024.10.014

Finlay A. McAlister MD, MSc , Anamaria Savu PhD , Luan Manh Chu PhD , Douglas C. Dover PhD , Padma Kaul PhD

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引用次数: 0

摘要

研究表明，COVID-19大流行对患者对慢性药物的依从性产生了负面影响。我们探讨了在COVID-19大流行发病后，长期接受心血管药物治疗的患者的依从性模式是否发生了变化。方法在这项回顾性队列研究中，我们检查了2017年至2023年期间至少使用1种心血管药物类别的所有成年阿尔伯塔人的药物分配数据。我们计算了每位患者在大流行前阶段（2018年3月15日至2020年3月14日）和大流行阶段（2020年3月15日至2022年3月14日）每种药物类别的覆盖天数比例（PDC），并使用广义估计方程逻辑回归来估计在调整年龄、性别、社会经济地位和合并症后，时间段对实现良好依从性（PDC >0.8）的影响。结果2018年3月15日至2022年3月14日期间，548601例至少使用1种心血管类药物的慢性使用者中，女性占47.2%，平均年龄为62.3岁，Charlson合并症指数（CCI）评分为0分的占55.4%。最常见的心血管药物是血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂（67.6%）和他汀类药物（53.8%）；最常见的诊断是高血压（77.2%）、糖尿病（30.6%）和缺血性心脏病（19.6%）。在大流行期间，心血管药物的慢性使用者比大流行前更可能有PDC >；0.8: 75.4% vs 72.8%，调整后的比值比从矿皮质激素受体拮抗剂的1.05（95%置信区间1.00-1.11）到他汀类药物的1.16（95%置信区间1.15-1.17）不等。结论新型冠状病毒肺炎大流行期间，慢性心血管药物使用者的依从性优于疫情前。

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The COVID-19 Pandemic Did Not Negatively Impact Adherence to Cardiovascular Medications Among 548,601 Chronically Treated Patients in Alberta

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The COVID-19 Pandemic Did Not Negatively Impact Adherence to Cardiovascular Medications Among 548,601 Chronically Treated Patients in Alberta

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.