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Erschienen in: Drugs & Aging 10/2019

18.07.2019 | Original Research Article

Potential Statin Overuse in Older Patients: A Retrospective Cross-Sectional Study Using French Health Insurance Databases

verfasst von: Emilie Borne, Nicolas Meyer, Marie-Christine Rybarczyck-Vigouret, Odile Blanchard, Martial Lombard, Pierre-Olivier Lang, Thomas Vogel, Bruno Michel

Erschienen in: Drugs & Aging | Ausgabe 10/2019

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Abstract

Background

Although compelling evidence exists supporting statins (HMG-CoA reductase inhibitors) for secondary prevention in older patients with clinical atherosclerotic diseases, the same cannot be said for primary prevention.

Objectives

The objectives of this study were to estimate the frequency of potential statin overuse in older patients, the potential drug cost savings if corrected, and the associated factors.

Methods

A retrospective cross-sectional study was conducted in Alsace and Lorraine (France) from 1 January to 30 April 2017. All statin users aged 80 years or over living in the community (including nursing homes) and identified from the French health insurance database were analyzed. Potential statin overuse was defined according to the STOPP/START (Screening Tool of Older People’s Prescriptions/Screening Tool to Alert to Right Treatment) criteria.

Results

Among the 38,268 aged insured, 23,228 (60.7%) had potential statin overuse. Of those living in the community, 22,132 (60.0%) patients had potential statin overuse: 12,352 (55.8%) for primary and 9780 (44.2%) for secondary prevention. Among nursing home residents, 1096 (79.0%) had potential statin overuse: 394 (35.9%) for primary and 702 (64.1%) for secondary prevention. The potential drug cost savings associated with the adjustment of potential statin overuse were €924,100 for the study period. Living in nursing home [adjusted odds ratio (ORadjusted) 3.91, 95% confidence interval (CI) 2.82–5.41] and being a female (ORadjusted 2.84, 95% CI 2.54–3.17) were the main risk factors associated with potential statin overuse.

Conclusion

The frequency of potential statin overuse is very high among older people aged 80 years or over, highlighting the need to re-evaluate statin therapy and consider deprescribing, particularly for primary prevention and in nursing homes.
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Metadaten
Titel
Potential Statin Overuse in Older Patients: A Retrospective Cross-Sectional Study Using French Health Insurance Databases
verfasst von
Emilie Borne
Nicolas Meyer
Marie-Christine Rybarczyck-Vigouret
Odile Blanchard
Martial Lombard
Pierre-Olivier Lang
Thomas Vogel
Bruno Michel
Publikationsdatum
18.07.2019
Verlag
Springer International Publishing
Erschienen in
Drugs & Aging / Ausgabe 10/2019
Print ISSN: 1170-229X
Elektronische ISSN: 1179-1969
DOI
https://doi.org/10.1007/s40266-019-00695-4

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