Prescription patterns of lipid lowering agents among older patients in general practice: an analysis from a national database in the Netherlands

E E F Kleipool, M M J Nielen, J C Korevaar, R E Harskamp, Y M Smulders, E Serné, A Thijs, M J L Peters, M Muller

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Dutch cardiovascular risk management guidelines state almost every older adult (≥70 years) is eligible for a lipid lowering drug (LLD). However, life expectancy, frailty or comorbidities may influence this treatment decision.

OBJECTIVE: investigate how many older adults, according to age, frailty (Drubbel-frailty index) and comorbidities were prescribed LLDs.

METHODS: data of 244,328 adults ≥70 years from electronic health records of 415 Dutch general practices from 2011-15 were used. Number of LLD prescriptions in patients with (n = 55,309) and without (n = 189,019) cardiovascular disease (CVD) was evaluated according to age, frailty and comorbidities.

RESULTS: about 69% of adults ≥70 years with CVD and 36% without CVD were prescribed a LLD. LLD prescriptions decreased with age; with CVD: 78% aged 70-74 years and 29% aged ≥90 years were prescribed a LLD, without CVD: 37% aged 70-74 years and 12% aged ≥90 years. In patients with CVD and within each age group, percentage of LLD prescriptions was 20% point(pp) higher in frail compared with non-frail. In patients without CVD, percentage of LLD prescriptions in frail patients was 11pp higher in adults aged 70-74 years and 40pp higher in adults aged ≥90 years compared to non-frail. Similar trends were seen in the analyses with number of comorbidities.

CONCLUSION: in an older population, LLD prescriptions decreased with age but-contrary to our expectations-LLD prescriptions increased with higher frailty levels.

Original languageEnglish
JournalAge and Ageing
Early online date26 Apr 2019
DOIs
Publication statusPublished - 26 Apr 2019

Cite this

@article{55a49f10d36d4c22b8b3819a45ed7468,
title = "Prescription patterns of lipid lowering agents among older patients in general practice: an analysis from a national database in the Netherlands",
abstract = "BACKGROUND: Dutch cardiovascular risk management guidelines state almost every older adult (≥70 years) is eligible for a lipid lowering drug (LLD). However, life expectancy, frailty or comorbidities may influence this treatment decision.OBJECTIVE: investigate how many older adults, according to age, frailty (Drubbel-frailty index) and comorbidities were prescribed LLDs.METHODS: data of 244,328 adults ≥70 years from electronic health records of 415 Dutch general practices from 2011-15 were used. Number of LLD prescriptions in patients with (n = 55,309) and without (n = 189,019) cardiovascular disease (CVD) was evaluated according to age, frailty and comorbidities.RESULTS: about 69{\%} of adults ≥70 years with CVD and 36{\%} without CVD were prescribed a LLD. LLD prescriptions decreased with age; with CVD: 78{\%} aged 70-74 years and 29{\%} aged ≥90 years were prescribed a LLD, without CVD: 37{\%} aged 70-74 years and 12{\%} aged ≥90 years. In patients with CVD and within each age group, percentage of LLD prescriptions was 20{\%} point(pp) higher in frail compared with non-frail. In patients without CVD, percentage of LLD prescriptions in frail patients was 11pp higher in adults aged 70-74 years and 40pp higher in adults aged ≥90 years compared to non-frail. Similar trends were seen in the analyses with number of comorbidities.CONCLUSION: in an older population, LLD prescriptions decreased with age but-contrary to our expectations-LLD prescriptions increased with higher frailty levels.",
author = "Kleipool, {E E F} and Nielen, {M M J} and Korevaar, {J C} and Harskamp, {R E} and Smulders, {Y M} and E Sern{\'e} and A Thijs and Peters, {M J L} and M Muller",
note = "{\circledC} The Author(s) 2019. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.",
year = "2019",
month = "4",
day = "26",
doi = "10.1093/ageing/afz034",
language = "English",
journal = "Age and Ageing",
issn = "0002-0729",
publisher = "Oxford University Press",

}

TY - JOUR

T1 - Prescription patterns of lipid lowering agents among older patients in general practice

T2 - an analysis from a national database in the Netherlands

AU - Kleipool, E E F

AU - Nielen, M M J

AU - Korevaar, J C

AU - Harskamp, R E

AU - Smulders, Y M

AU - Serné, E

AU - Thijs, A

AU - Peters, M J L

AU - Muller, M

N1 - © The Author(s) 2019. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

PY - 2019/4/26

Y1 - 2019/4/26

N2 - BACKGROUND: Dutch cardiovascular risk management guidelines state almost every older adult (≥70 years) is eligible for a lipid lowering drug (LLD). However, life expectancy, frailty or comorbidities may influence this treatment decision.OBJECTIVE: investigate how many older adults, according to age, frailty (Drubbel-frailty index) and comorbidities were prescribed LLDs.METHODS: data of 244,328 adults ≥70 years from electronic health records of 415 Dutch general practices from 2011-15 were used. Number of LLD prescriptions in patients with (n = 55,309) and without (n = 189,019) cardiovascular disease (CVD) was evaluated according to age, frailty and comorbidities.RESULTS: about 69% of adults ≥70 years with CVD and 36% without CVD were prescribed a LLD. LLD prescriptions decreased with age; with CVD: 78% aged 70-74 years and 29% aged ≥90 years were prescribed a LLD, without CVD: 37% aged 70-74 years and 12% aged ≥90 years. In patients with CVD and within each age group, percentage of LLD prescriptions was 20% point(pp) higher in frail compared with non-frail. In patients without CVD, percentage of LLD prescriptions in frail patients was 11pp higher in adults aged 70-74 years and 40pp higher in adults aged ≥90 years compared to non-frail. Similar trends were seen in the analyses with number of comorbidities.CONCLUSION: in an older population, LLD prescriptions decreased with age but-contrary to our expectations-LLD prescriptions increased with higher frailty levels.

AB - BACKGROUND: Dutch cardiovascular risk management guidelines state almost every older adult (≥70 years) is eligible for a lipid lowering drug (LLD). However, life expectancy, frailty or comorbidities may influence this treatment decision.OBJECTIVE: investigate how many older adults, according to age, frailty (Drubbel-frailty index) and comorbidities were prescribed LLDs.METHODS: data of 244,328 adults ≥70 years from electronic health records of 415 Dutch general practices from 2011-15 were used. Number of LLD prescriptions in patients with (n = 55,309) and without (n = 189,019) cardiovascular disease (CVD) was evaluated according to age, frailty and comorbidities.RESULTS: about 69% of adults ≥70 years with CVD and 36% without CVD were prescribed a LLD. LLD prescriptions decreased with age; with CVD: 78% aged 70-74 years and 29% aged ≥90 years were prescribed a LLD, without CVD: 37% aged 70-74 years and 12% aged ≥90 years. In patients with CVD and within each age group, percentage of LLD prescriptions was 20% point(pp) higher in frail compared with non-frail. In patients without CVD, percentage of LLD prescriptions in frail patients was 11pp higher in adults aged 70-74 years and 40pp higher in adults aged ≥90 years compared to non-frail. Similar trends were seen in the analyses with number of comorbidities.CONCLUSION: in an older population, LLD prescriptions decreased with age but-contrary to our expectations-LLD prescriptions increased with higher frailty levels.

UR - http://www.mendeley.com/research/prescription-patterns-lipid-lowering-agents-among-older-patients-general-practice-analysis-national

U2 - 10.1093/ageing/afz034

DO - 10.1093/ageing/afz034

M3 - Article

JO - Age and Ageing

JF - Age and Ageing

SN - 0002-0729

ER -