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Medication Underuse in Aging Outpatients with Cardiovascular Disease: Prevalence, Determinants, and Outcomes in a Prospective Cohort Study

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Medication Underuse in Aging Outpatients with Cardiovascular Disease: Prevalence, Determinants, and Outcomes in a Prospective Cohort Study. / Meid, Andreas D; Quinzler, Renate; Freigofas, Julia; Saum, Kai-Uwe; Schöttker, Ben; Holleczek, Bernd; Heider, Dirk; König, Hans-Helmut; Brenner, Hermann; Haefeli, Walter E.

In: PLOS ONE, Vol. 10, No. 8, 2015, p. e0136339.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Meid, AD, Quinzler, R, Freigofas, J, Saum, K-U, Schöttker, B, Holleczek, B, Heider, D, König, H-H, Brenner, H & Haefeli, WE 2015, 'Medication Underuse in Aging Outpatients with Cardiovascular Disease: Prevalence, Determinants, and Outcomes in a Prospective Cohort Study', PLOS ONE, vol. 10, no. 8, pp. e0136339. https://doi.org/10.1371/journal.pone.0136339

APA

Meid, A. D., Quinzler, R., Freigofas, J., Saum, K-U., Schöttker, B., Holleczek, B., Heider, D., König, H-H., Brenner, H., & Haefeli, W. E. (2015). Medication Underuse in Aging Outpatients with Cardiovascular Disease: Prevalence, Determinants, and Outcomes in a Prospective Cohort Study. PLOS ONE, 10(8), e0136339. https://doi.org/10.1371/journal.pone.0136339

Vancouver

Meid AD, Quinzler R, Freigofas J, Saum K-U, Schöttker B, Holleczek B et al. Medication Underuse in Aging Outpatients with Cardiovascular Disease: Prevalence, Determinants, and Outcomes in a Prospective Cohort Study. PLOS ONE. 2015;10(8):e0136339. https://doi.org/10.1371/journal.pone.0136339

Bibtex

@article{efb3bbdc0f2348c6932aa5a68facfca7,
title = "Medication Underuse in Aging Outpatients with Cardiovascular Disease: Prevalence, Determinants, and Outcomes in a Prospective Cohort Study",
abstract = "BACKGROUND: Cardiovascular disease is a leading cause of death in older people, and the impact of being exposed or not exposed to preventive cardiovascular medicines is accordingly high. Underutilization of beneficial drugs is common, but prevalence estimates differ across settings, knowledge on predictors is limited, and clinical consequences are rarely investigated.METHODS: Using data from a prospective population-based cohort study, we assessed the prevalence, determinants, and outcomes of medication underuse based on cardiovascular criteria from Screening Tool To Alert to Right Treatment (START).RESULTS: Medication underuse was present in 69.1% of 1454 included participants (mean age 71.1 ± 6.1 years) and was significantly associated with frailty (odds ratio: 2.11 [95% confidence interval: 1.24-3.63]), body mass index (1.03 [1.01-1.07] per kg/m2), and inversely with the number of prescribed drugs (0.84 [0.79-0.88] per drug). Using this information for adjustment in a follow-up evaluation (mean follow-up time 2.24 years) on cardiovascular and competing outcomes, we found no association of medication underuse with cardiovascular events (fatal and non-fatal) (hazard ratio: 1.00 [0.65-1.56]), but observed a significant association of medication underuse with competing deaths from non-cardiovascular causes (2.52 [1.01-6.30]).CONCLUSION: Medication underuse was associated with frailty and adverse non-cardiovascular clinical outcomes. This may suggest that cardiovascular drugs were withheld because of serious co-morbidity or that concurrent illness can preclude benefit from cardiovascular prevention. In the latter case, adapted prescribing criteria should be developed and evaluated in those patients.",
author = "Meid, {Andreas D} and Renate Quinzler and Julia Freigofas and Kai-Uwe Saum and Ben Sch{\"o}ttker and Bernd Holleczek and Dirk Heider and Hans-Helmut K{\"o}nig and Hermann Brenner and Haefeli, {Walter E}",
year = "2015",
doi = "10.1371/journal.pone.0136339",
language = "English",
volume = "10",
pages = "e0136339",
journal = "PLOS ONE",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "8",

}

RIS

TY - JOUR

T1 - Medication Underuse in Aging Outpatients with Cardiovascular Disease: Prevalence, Determinants, and Outcomes in a Prospective Cohort Study

AU - Meid, Andreas D

AU - Quinzler, Renate

AU - Freigofas, Julia

AU - Saum, Kai-Uwe

AU - Schöttker, Ben

AU - Holleczek, Bernd

AU - Heider, Dirk

AU - König, Hans-Helmut

AU - Brenner, Hermann

AU - Haefeli, Walter E

PY - 2015

Y1 - 2015

N2 - BACKGROUND: Cardiovascular disease is a leading cause of death in older people, and the impact of being exposed or not exposed to preventive cardiovascular medicines is accordingly high. Underutilization of beneficial drugs is common, but prevalence estimates differ across settings, knowledge on predictors is limited, and clinical consequences are rarely investigated.METHODS: Using data from a prospective population-based cohort study, we assessed the prevalence, determinants, and outcomes of medication underuse based on cardiovascular criteria from Screening Tool To Alert to Right Treatment (START).RESULTS: Medication underuse was present in 69.1% of 1454 included participants (mean age 71.1 ± 6.1 years) and was significantly associated with frailty (odds ratio: 2.11 [95% confidence interval: 1.24-3.63]), body mass index (1.03 [1.01-1.07] per kg/m2), and inversely with the number of prescribed drugs (0.84 [0.79-0.88] per drug). Using this information for adjustment in a follow-up evaluation (mean follow-up time 2.24 years) on cardiovascular and competing outcomes, we found no association of medication underuse with cardiovascular events (fatal and non-fatal) (hazard ratio: 1.00 [0.65-1.56]), but observed a significant association of medication underuse with competing deaths from non-cardiovascular causes (2.52 [1.01-6.30]).CONCLUSION: Medication underuse was associated with frailty and adverse non-cardiovascular clinical outcomes. This may suggest that cardiovascular drugs were withheld because of serious co-morbidity or that concurrent illness can preclude benefit from cardiovascular prevention. In the latter case, adapted prescribing criteria should be developed and evaluated in those patients.

AB - BACKGROUND: Cardiovascular disease is a leading cause of death in older people, and the impact of being exposed or not exposed to preventive cardiovascular medicines is accordingly high. Underutilization of beneficial drugs is common, but prevalence estimates differ across settings, knowledge on predictors is limited, and clinical consequences are rarely investigated.METHODS: Using data from a prospective population-based cohort study, we assessed the prevalence, determinants, and outcomes of medication underuse based on cardiovascular criteria from Screening Tool To Alert to Right Treatment (START).RESULTS: Medication underuse was present in 69.1% of 1454 included participants (mean age 71.1 ± 6.1 years) and was significantly associated with frailty (odds ratio: 2.11 [95% confidence interval: 1.24-3.63]), body mass index (1.03 [1.01-1.07] per kg/m2), and inversely with the number of prescribed drugs (0.84 [0.79-0.88] per drug). Using this information for adjustment in a follow-up evaluation (mean follow-up time 2.24 years) on cardiovascular and competing outcomes, we found no association of medication underuse with cardiovascular events (fatal and non-fatal) (hazard ratio: 1.00 [0.65-1.56]), but observed a significant association of medication underuse with competing deaths from non-cardiovascular causes (2.52 [1.01-6.30]).CONCLUSION: Medication underuse was associated with frailty and adverse non-cardiovascular clinical outcomes. This may suggest that cardiovascular drugs were withheld because of serious co-morbidity or that concurrent illness can preclude benefit from cardiovascular prevention. In the latter case, adapted prescribing criteria should be developed and evaluated in those patients.

U2 - 10.1371/journal.pone.0136339

DO - 10.1371/journal.pone.0136339

M3 - SCORING: Journal article

C2 - 26288222

VL - 10

SP - e0136339

JO - PLOS ONE

JF - PLOS ONE

SN - 1932-6203

IS - 8

ER -