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

Use of Lipid-Lowering Drugs and Associated Outcomes According to Health State Profiles in Hospitalized Older Patients

“…On the whole, their health state profile apparently justifies the low prevalence of statin use, in agreement with guidelines and recommendations stemming from the literature, 4–8 , 31 , 32 but in contrast with the findings of Borne et al, who observed an overuse of statins for primary prevention in the community-dwelling population aged 80 years or more. 33 The observed relatively low prevalence of drug–drug interactions, albeit increasing in Cluster III further supports our concluding remark of an overall proper use of LLDs in this hospitalized population of older patients.…”

Statin (mis)use in older people: A cross‐sectional study using French health insurance databases

“…Drugs were coded according to the Anatomical Therapeutic Chemical (ATC) classification system. For statins, in France five statins were commercially (atorvastatin, fluvastatin, pravastatin, rosuvastatin, simvastatin), and were considered for the present study as well as two fixed combination of statin with ezetimibe 13 …”

“…Off‐label uses were for an unapproved indication, which are in France atorvastatin and rosuvastatin for secondary prevention indication 9,14 . To define this indication, we considered three cardiovascular ALD (Long‐term/major illness) and reimbursements for specific cardiovascular drugs 13 . Cardiovascular ALD considered were ALD1 for disabling stroke, ALD3 for chronic arteriopathy with ischemic manifestations and ALD13 for coronary heart disease.…”

“…Homeopathy and dermatological drugs were not considered 18 . Chronic comorbid conditions were identified from specific drugs with their ATC code 13 . The presence of two or more chronic comorbid conditions defined multimorbidity 19 …”

“…Specific cardiovascular drugs considered were the class of platelet aggregation inhibitors as well as vasodilatators, ivabradine, naftidrofuryl and pentoxiphylline, respectively identified by their ATC codes. 13 High-intensity doses are associated to an increased risk of ADRs which explains that guidelines recommended low or moderate doses of statin therapy in older people. 9,15 High statin doses were defined as followed (HAS, French National Authority for Health):20 mg or more for atorvastatin, atorvastatin fixed combination with ezetimibe and 10 mg or more for rosuvastatin.…”