Abstract
Background
Older patients are prone to multimorbidity and polypharmacy, with an inherent risk of adverse events and drug interactions. To the best of our knowledge, available information on the appropriateness of lipid-lowering treatment is extremely limited.
Aim
The aim of the present study was to quantify and characterize lipid-lowering drug use in a population of complex in-hospital older patients.
Methods
We analyzed data from 87 units of internal medicine or geriatric medicine in the REPOSI (Registro Politerapie della Società Italiana di Medicina Interna) study, with reference to the 2010 and 2012 patient cohorts. Lipid-lowering drug use was closely correlated with the clinical profiles, including multimorbidity markers and polypharmacy.
Results
2171 patients aged >65 years were enrolled (1057 males, 1114 females, mean age 78.6 years). The patients treated with lipid-lowering drugs amounted to 508 subjects (23.4%), with no gender difference. Atorvastatin (39.3%) and simvastatin (34.0%) were the most widely used statin drugs. Likelihood of treatment was associated with polypharmacy (≥5 drugs) and with higher Cumulative Illness Rating Scale (CIRS) score. At logistic regression analysis, the presence of coronary heart disease, peripheral vascular disease, and hypertension were significantly correlated with lipid-lowering drug use, whereas age showed an inverse correlation. Diabetes was not associated with drug treatment.
Conclusions
In this in-hospital cohort, the use of lipid-lowering agents was mainly driven by patients’ clinical history, most notably the presence of clinically overt manifestations of atherosclerosis. Increasing age seems to be associated with lower prescription rates. This might be indicative of cautious behavior towards a potentially toxic treatment regimen.
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Acknowledgements
The authors wish to thank Prof. Pier Mannuccio Mannucci, University of Milan, for reviewing the paper and for helpful and valuable comments.
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Marco Bertolotti, Carlotta Franchi, Marco B.L. Rocchi, Andrea Miceli, M. Vittoria Libbra, Alessandro Nobili, Giulia Lancellotti, Lucia Carulli, and Chiara Mussi declare that they have no conflict of interest that might be relevant to the contents of this manuscript.
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Bertolotti, M., Franchi, C., Rocchi, M.B.L. et al. Prevalence and Determinants of the Use of Lipid-Lowering Agents in a Population of Older Hospitalized Patients: the Findings from the REPOSI (REgistro POliterapie Società Italiana di Medicina Interna) Study. Drugs Aging 34, 311–319 (2017). https://doi.org/10.1007/s40266-017-0448-8
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DOI: https://doi.org/10.1007/s40266-017-0448-8