6533b85cfe1ef96bd12bd61d

RESEARCH PRODUCT

Prevalence and Determinants of the Use of Lipid-Lowering Agents in a Population of Older Hospitalized Patients: the Findings from the REPOSI (REgistro POliterapie Società Italiana di Medicina Interna) Study

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subject

Malemedicine.medical_specialtyLogistic ModelLipid-Lowering AgentsPopulationSocio-culturaleOlder Hospitalized Patients030204 cardiovascular system & hematologyGeriatrics and Gerontology; Pharmacology (medical)03 medical and health sciences0302 clinical medicineInternal medicine80 and overPrevalencemedicineHumansPharmacology (medical)030212 general & internal medicineMedical prescriptionIntensive care medicineOmega 3 fatty acideducationAdverse effectAgedHypolipidemic AgentsAged 80 and overPolypharmacyGeriatricseducation.field_of_studyHypolipidemic Agentbusiness.industryGeriatrics and Gerontology Pharmacology (medical)HospitalizationLogistic ModelsCohortPolypharmacyAged; Aged 80 and over; Female; Hospitalization; Humans; Hypolipidemic Agents; Logistic Models; Male; Polypharmacy; Prevalence; Geriatrics and Gerontology; Pharmacology (medical)FemaleGeriatrics and GerontologybusinessAged; Aged 80 and over; Female; Hospitalization; Humans; Hypolipidemic Agents; Logistic Models; Male; Polypharmacy; PrevalenceHumanCohort study

description

BACKGROUND: Older patients are prone to multimorbidity and polypharmacy, with an inherent risk of adverse events and drug interactions. To the best of our knowledge, available information on the appropriateness of lipid-lowering treatment is extremely limited. AIM: The aim of the present study was to quantify and characterize lipid-lowering drug use in a population of complex in-hospital older patients. METHODS: We analyzed data from 87 units of internal medicine or geriatric medicine in the REPOSI (Registro Politerapie della Società Italiana di Medicina Interna) study, with reference to the 2010 and 2012 patient cohorts. Lipid-lowering drug use was closely correlated with the clinical profiles, including multimorbidity markers and polypharmacy. RESULTS: 2171 patients aged >65 years were enrolled (1057 males, 1114 females, mean age 78.6 years). The patients treated with lipid-lowering drugs amounted to 508 subjects (23.4%), with no gender difference. Atorvastatin (39.3%) and simvastatin (34.0%) were the most widely used statin drugs. Likelihood of treatment was associated with polypharmacy (≥5 drugs) and with higher Cumulative Illness Rating Scale (CIRS) score. At logistic regression analysis, the presence of coronary heart disease, peripheral vascular disease, and hypertension were significantly correlated with lipid-lowering drug use, whereas age showed an inverse correlation. Diabetes was not associated with drug treatment. CONCLUSIONS: In this in-hospital cohort, the use of lipid-lowering agents was mainly driven by patients' clinical history, most notably the presence of clinically overt manifestations of atherosclerosis. Increasing age seems to be associated with lower prescription rates. This might be indicative of cautious behavior towards a potentially toxic treatment regimen

yearjournalcountryeditionlanguage
2017-01-01
10.1007/s40266-017-0448-8http://hdl.handle.net/20.500.11769/299642