Temporal trends in the utilisation of preventive medicines by older people: A 9-year population-based study |
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| Affiliation: | 1. University of Chicago, Department of Medicine, Section of Geriatrics and Palliative Medicine, USA;2. University of Chicago, Department of Public Health Sciences, University of Chicago, USA;3. University of Chicago, Department of Sociology and NORC, Center on Aging, USA;1. Institute for Cardiovascular Sciences, University of Birmingham, Birmingham, UK;2. Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Centre for Heart Diseases, Zabrze, Poland;3. Division of Family Practice, Chilliwack General Hospital, Chilliwack, British Columbia, Canada;1. Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637007, Sichuan Province, China;2. Department of Ophthalmology and Optometry, North Sichuan Medical College, Nanchong 637007, Sichuan Province, China;3. Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hunghom, Hong Kong, China;1. Cardiology Department, Health Sciences North, Sudbury, Ontario, Canada;2. Health Sciences North Research Institute, Sudbury, Ontario, Canada;3. Northern Ontario School of Medicine, Laurentian University, Sudbury, Ontario, Canada;4. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada;5. Division of Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada;6. Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada;7. Electrophysiology Unit, Cardiology Department, Hillel Yaffe Medical Center, Hadera, Israel;8. Department of Medicine, University of Toronto, Toronto, Ontario, Canada;9. Medical Pharmacies Group Limited, Toronto, Ontario, Canada |
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| Abstract: | ![]()
BackgroundFor older individuals with multimorbidity the appropriateness of prescribing preventive medicines remains a challenge.ObjectiveInvestigate the prevalence and temporal trends in utilisation of preventive medicines in older New Zealanders from 2005 to 2013 stratified according to age, sex, ethnicity and district health board domicile.MethodsA repeated cross-sectional analysis was conducted on pharmaceutical dispensing data for all individuals’ ≥65 years. Variable medication possession ratio (VMPR) was used to measure adherence. Prescribing of low-dose aspirin, clopidogrel, dipyridamole, warfarin, dabigatran, statins and bisphosphonates with a VMPR ≥ 0.8 were examined.ResultsAspirin utilisation increased by 19.55% (95% CI: 19.39–19.70), clopidogrel by 2.93% (95% CI: 2.88–2.97) and dipyridamole decreased by 0.65% (95% CI: −0.70 to −0.59). Utilisation of aspirin with clopidogrel increased by 1.78% (95% CI: 1.74–1.81) and aspirin with dipyridamole increased by 0.54% (95% CI: 0.50–0.58%).Warfarin decreased by 0.87% (95% CI: −0.96 to −0.78) and dabigatran increased by 0.65% (95% CI: 0.60–0.70). Statins increased by 7.0% (95% CI: 6.82–7.18) and bisphosphonates decreased by 2.37% (95% CI: −2.44 to −2.30). Aspirin, clopidogrel, dabigatran and statins utilisation showed a greater increase in males. Interestingly, clopidogrel, warfarin and statins use increased in older adults aged 85+ compared to the younger age groups (65–84 years).ConclusionTo our knowledge, this is the first study investigating the prevalence and trends of preventive medicines use in older people in New Zealand. This study may facilitate further research to examine the appropriateness of prescribing these medicines in older people with multimorbidity. |
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| Keywords: | Preventive medicines Older people Antithrombotics Statins Bisphosphonates |
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