학술논문

Patterns of Lipid Lowering Therapy Use Among Older Adults in a Managed Care Advantage Plan in the United States.
Document Type
Article
Source
Journal of Pharmacy Practice. Feb2024, Vol. 37 Issue 1, p123-131. 9p.
Subject
*PATIENT aftercare
*STATINS (Cardiovascular agents)
*ANTILIPEMIC agents
*MANAGED care programs
*COMBINATION drug therapy
*RETROSPECTIVE studies
*ACQUISITION of data
*DRUG prescribing
*MEDICAL records
*DESCRIPTIVE statistics
*PHYSICIAN practice patterns
*TERMINATION of treatment
*OLD age
Language
ISSN
0897-1900
Abstract
Background: The prevalence of cardiovascular events is increasing. There are many new lipids lowering therapies available in recent years. Increased evidence through literature and guidelines suggests that the use of lipid lowering therapy (LLT) benefits patients who are at risk for cardiovascular events. Objective: The objective of this study was to describe the current LLT use as well as patterns of treatment modification among adults ≥ 65 years. Methods: A retrospective analysis of administrative claims data between January 2016 and May 2018 was conducted. Patients with a LLT refill and continuous enrollment during 1-year prior and 1-year follow-up were identified. The treatment episodes captured were interruption of therapy, intensity changes, dose changes, treatment augmentation, switching, and discontinuation. An analysis of treatment patterns among patients ≥75 years was also performed. Results: The study included 14,360 patients with a LLT of which 99% of patients were on statins as monotherapy or combination. Overall non-statin therapy use either as monotherapy or combination was 2.1%. There were significant differences among new initiators and existing users of therapy. Among prevalent users 57.4% had no changes in the follow-up period, 13.6% interrupted therapy, and 6.6% discontinued. Among new users, 47.9% patients had interrupted therapy, 25% had no changes, and 21.9% discontinued therapy. Conclusion: Most patients were on monotherapy and statins with low non-statin use. The new users among them were more likely to discontinue and interrupt therapy, highlighting the limitations and issues that older patients face that need to increase adherence. [ABSTRACT FROM AUTHOR]