Publicatie

Publication date

Prescription patterns of lipid lowering agents among older patients in general practice: an analysis from a national database in the Netherlands.

Kleipool, E.E.F., Nielen, M.M.J., Korevaar, J.C., Harskamp, R.E., Smulders, Y., Serné, E., Thijs, A., Peters, M.J.L., Muller, M. Prescription patterns of lipid lowering agents among older patients in general practice: an analysis from a national database in the Netherlands. Age and Ageing: 2019(4), 577-582
Download the PDF
Background
Dutch cardiovascular risk management guidelines state almost every older adult (≥70 years) is eligible for a lipid lowering drug (LLD). However, life expectancy, frailty or comorbidities may influence this treatment decision.

Objective
Investigate how many older adults, according to age, frailty (Drubbel-frailty index) and comorbidities were prescribed LLDs.

Methods
Data of 244,328 adults ≥70 years from electronic health records of 415 Dutch general practices from 2011–15 were used. Number of LLD prescriptions in patients with (n = 55,309) and without (n = 189,019) cardiovascular disease (CVD) was evaluated according to age, frailty and comorbidities.

Results
About 69% of adults ≥70 years with CVD and 36% without CVD were prescribed a LLD. LLD prescriptions decreased with age; with CVD: 78% aged 70–74 years and 29% aged ≥90 years were prescribed a LLD, without CVD: 37% aged 70–74 years and 12% aged ≥90 years. In patients with CVD and within each age group, percentage of LLD prescriptions was 20% point(pp) higher in frail compared with non-frail. In patients without CVD, percentage of LLD prescriptions in frail patients was 11pp higher in adults aged 70–74 years and 40pp higher in adults aged ≥90 years compared to non-frail. Similar trends were seen in the analyses with number of comorbidities.

Conclusion
In an older population, LLD prescriptions decreased with age but—contrary to our expectations—LLD prescriptions increased with higher frailty levels.