Statin utilization according to indication and age: A Danish cohort study on changing prescribing and purchasing behaviour

Kildemoes, Helle Wallach; Vass, Mikkel; Hendriksen, Carsten; Andersen, Morten

doi:10.1016/j.healthpol.2012.08.008

Cited by 34 publications

(28 citation statements)

References 80 publications

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“…By means of the nationwide Danish registers and the register‐based proxies for statin prescribing indication [36], we have shown that statin therapy is increasingly initiated among older persons and individuals with neither CVD nor diabetes [37] and that the pattern of statin utilization according to indication, gender and age differs between prevalent and incident statin users [36]. However, to assess whether the high incidence and prevalence of statin therapy is appropriate, statin prescribing patterns must be related to evidence about the beneficial effects of therapy versus adverse effects.…”

Section: Introductionmentioning

confidence: 99%

Statin prescribing according to gender, age and indication: what about the benefit–risk balance?

Kildemoes

Støvring

Hansen³

et al. 2015

Evaluation Clinical Practice

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Rationales, aims and objectives The increasing dispensing of statins has raised concern about the appropriateness of prescribing to various population groups. We aimed to (1) investigate incident and prevalent statin prescribing according to indication, gender and age and (2) relate prescribing patterns to evidence on beneficial and adverse effects. Methods A cohort of Danish inhabitants (n = 4 424 818) was followed in nationwide registries for dispensed statin prescriptions and hospital discharge information. We calculated incidence rates (2005-2009), prevalence trends (2000-2010) and absolute numbers of statin users according to register proxies for indication, gender and age. Results In 2010, the prevalence became highest for ages 75-84 and was higher in men than women (37% and 33%, respectively). Indication-specific incidences and prevalences peaked at ages around 65-70, but in myocardial infarction, the prevalence was about 80% at ages 45-80. Particularly, incidences tended to be lower in women until ages of about 60 where after gender differences were negligible. In asymptomatic individuals (hypercholesterolaemia, presumably only indication) aged 50+, dispensing was highest in women. The fraction of statin dispensing for primary prevention decreased with age: higher for incident than prevalent prescribing. Independent of age, this fraction was highest among women, e.g. 60% versus 45% at ages 55-64. The fraction for potential atherosclerotic condition (PAC, e.g. heart failure) increased with age. Conclusion Prevalence of statin utilization was highest for ages 75-84, although indication-specific measures were relatively low. Despite inconclusive evidence for a favourable risk-benefit balance, statin prescribing was high among people aged 80+, asymptomatic women and PAC patients.

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Section: Introductionmentioning

confidence: 99%

Statin prescribing according to gender, age and indication: what about the benefit–risk balance?

Kildemoes

Støvring

Hansen³

et al. 2015

Evaluation Clinical Practice

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“…In Australia, statins are used by 43% of community‐dwelling people aged ≥75 years . Other recent international studies of older people reported statin prevalence of 12.9–33.1% . Although the benefits of statins in reducing the risk of cardiovascular events are well established in younger populations, the evidence on the benefits of statins in older people is less clear .…”

Section: Baseline Characteristics Of the Study Population According Tmentioning

confidence: 99%

Statin utilisation patterns in older Australians living in residential care: 1‐year prevalence study

Gnjidic

Wilson

March

et al. 2015

Internal Medicine Journal

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Despite controversy over the risks and benefits of statin therapy, statins continue to be commonly used medicines by older people. In a cohort study of participants aged ≥70 years (n = 540) living in residential care, Sydney, we found that the proportion of statin users decreased gradually from the baseline of 33.1% to 31.3% at 6 months (P = 0.13) and to 28.7% over 1 year (P = 0.002). Prevalence of statin use decreased with increasing age, with individuals aged ≥90 years being more likely to discontinue or deprescribe statins. The patterns of statin use did not change according to increasing baseline dose or baseline indication.

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“…Statins (Hydroxymethylglutaryl‐coenzyme A reductase inhibitors) lower cholesterol in blood and thereby prevent cardiovascular events . Statins were first marketed in Denmark in 1990, and the prevalence of statin treatment in Denmark increased from seven per 1000 inhabitants in 1996 to 187 per 1000 in 2010. Apart from protection against cardiovascular conditions, statins affect immune function and may reduce risk of other diseases including cancer .…”

Section: Introductionmentioning

confidence: 99%

Validating registry data on statins prescriptions by blood measurements

Riis

Erichsen

Ostenfeld

et al. 2019

Pharmacoepidemiology and Drug

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Purpose To validate prescription registry data as a measurement of adherence to statins through a direct method using assays for selected statins in serial blood samples collected from two prospective cohorts of Danish colorectal cancer patients. Methods We linked information on statin prescriptions from the Aarhus University Prescription Database with the cancer cohorts from Aalborg University Hospital. For statin‐prescribed patients, we calculated a prescription window covering the anticipated duration of the prescription. For each statin‐prescribed patient with at least one blood sample in a prescription window, we selected without replacement a never–statin‐prescribed patient matched on sex, age, and calendar year of surgery. Each of the selected blood samples were analyzed using assays to detect statins. We calculated the positive and negative predictive value of the prescription registry reporting using the assay result as the gold standard. Results We identified 73 ever–statin‐prescribed patients with a total of 253 blood samples and 74 blood samples among never–statin‐prescribed patients. The positive predictive value for prescribed patients, with presence of statins in at least one blood sample as the gold standard, was 93% (95% CI, 86%‐97%) and the negative predictive value was 93% (95% CI, 86%‐97%). Stratified results did not reveal substantial differences in predictive values. Fifty‐two (71%) of the statin‐prescribed patients had statins in every blood sample, suggesting continuous adherence. Conclusion This study showed a high adherence with treatment with statins among colorectal cancer patients.

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Statin utilization according to indication and age: A Danish cohort study on changing prescribing and purchasing behaviour

Cited by 34 publications

References 80 publications

Statin prescribing according to gender, age and indication: what about the benefit–risk balance?

Statin prescribing according to gender, age and indication: what about the benefit–risk balance?

Statin utilisation patterns in older Australians living in residential care: 1‐year prevalence study

Validating registry data on statins prescriptions by blood measurements

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