Statin utilisation patterns in older <scp>A</scp>ustralians living in residential care: 1‐year prevalence study

Gnjidic, Danijela; Wilson, Nicholas; March, L.; Cumming, Robert G.; Cameron, ID; Hilmer, Sarah N.

doi:10.1111/imj.12633

Cited by 8 publications

(3 citation statements)

References 20 publications

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“…Statins were chosen as a medication class to illustrate the concept as they are commonly prescribed for older people . They are indicated to reduce cholesterol with the intention to reduce premature mortality and to reduce the risk of cardiovascular events such as myocardial infarction and stroke .…”

Section: Resultsmentioning

confidence: 99%

“…73 They are indicated to reduce cholesterol with the intention to reduce premature mortality and to reduce the risk of cardiovascular events such as myocardial infarction and stroke. 74 For healthy older adults without established cardiovascular disease, use of statins for primary prevention may reduce risk of myocardial infarction or ischaemic stroke, but does not alter all-cause mortality.…”

Section: Consideration For a Particular Medicationmentioning

confidence: 99%

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A concept analysis of deprescribing medications in older people

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Clifford

Potter³

et al. 2018

Pharmacy Practice and Res

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Aim: Deprescribing is an increasingly common term in the literature, although no specific accepted definition exists. We aimed to clarify the concept of deprescribing as used in research and clinical practice. Methods: Deprescribing was examined using the eight-step Walker and Avant method of concept analysis that consisted of: (i) concept selection; (ii) determining the purpose of the analysis; (iii) identifying uses of the concept; (iv) determining the critical attributes; (v) identifying the model case; (vi) identifying borderline and contrary cases; (vii) identifying antecedents and consequences; and (viii) defining empirical referents. A literature search was conducted on the word de?prescri*. Results: We identified seven critical attributes: withdrawing medications, de-escalation, intended outcomes, structured and iterative process, intervention, risk to benefit, and patient-centred care. Deprescribing antecedents were identified as changing health, changing goals for health care, and polypharmacy. Deprescribing consequences identified were compliance, health outcomes, mortality and cost, and possibility for adverse drug withdrawal events to occur. We used the model case, borderline and contrary cases and empirical referents to illustrate the concept of deprescribing. Conclusions: Deprescribing is a term used with varying degrees of precision, and there is no accepted definition. In this paper, we have analysed the concept of deprescribing and identified it as a patient-centred process of medication withdrawal intended to achieve improved health outcomes through discontinuation of one or more medications that are either potentially harmful or no longer required.

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Section: Resultsmentioning

confidence: 99%

Section: Consideration For a Particular Medicationmentioning

confidence: 99%

A concept analysis of deprescribing medications in older people

Page

Clifford

Potter³

et al. 2018

Pharmacy Practice and Res

View full text Add to dashboard Cite

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“…There was a trend toward hydrophilic statin use, which may be related to the growing favourability of rosuvastatin over atorvastatin in terms of potency, efficacy and safety [22][23][24][25]. Furthermore, despite recent meta-analyses suggesting that statin therapy was effective and safe in the elderly [26], medication usage was significantly lower in those aged ≥85 years compared with other age groups, reflecting prior beliefs that statins provide little benefit to the elderly [15,27]. These trends highlighted the fact that physicians responded to emerging findings in the literature but that it took several years for new evidence to translate into general practice.…”

Section: Discussionmentioning

confidence: 99%

Statin Prescription Patterns and Associations with Subclinical Inflammation

et al. 2022

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Background and Objectives: Statins have been extensively utilised in atherosclerotic cardiovascular disease (ASCVD) prevention and can inhibit inflammation. However, the association between statin therapy, subclinical inflammation and associated health outcomes is poorly understood in the primary care setting. Materials and Methods: Primary care electronic health record (EHR) data from the electronic Practice-Based Research Network (ePBRN) from 2012–2019 was used to assess statin usage and adherence in South-Western Sydney (SWS), Australia. Independent determinants of elevated C-reactive protein (CRP) were determined. The relationship between baseline CRP levels and hospitalisation rates at 12 months was investigated. Results: The prevalence of lipid-lowering medications was 14.0% in all adults and 44.6% in the elderly (≥65 years). The prevalence increased from 2012 to 2019 despite a drop in statin use between 2013–2015. A total of 55% of individuals had good adherence (>80%). Hydrophilic statin use and higher intensity statin therapy were associated with elevated CRP levels. However, elevated CRP levels were not associated with all-cause or ASCVD hospitalisations after adjusting for confounders. Conclusions: The prevalence and adherence patterns associated with lipid-lowering medications highlighted the elevated ASCVD-related burden in the SWS population, especially when compared with the Australian general population. Patients in SWS may benefit from enhanced screening protocols, targeted health literacy and promotion campaigns, and timely incorporation of evidence into ASCVD clinical guidelines. This study, which used EHR data, did not support the use of CRP as an independent marker of future short-term hospitalisations.

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