학술논문

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
Document Type
Original Paper
Author
Bertolotti, MarcoFranchi, CarlottaRocchi, Marco B. L.Miceli, AndreaLibbra, M. VittoriaNobili, AlessandroLancellotti, GiuliaCarulli, LuciaMussi, ChiaraMannucci, Pier MannuccioNobili, AlessandroTettamanti, MauroPasina, LucaFranchi, CarlottaPerticone, FrancescoSalerno, FrancescoCorrao, SalvatoreMarengoni, AlessandraLicata, GiuseppeVioli, FrancescoCorazza, Gino RobertoMarcucci, MauraEldin, Tarek KamalDi Blanca, Maria Pia DonatellaLanzo, GiovannaAstuto, SarahTettamanti, MauroArdoino, IlariaCortesi, LauraPrisco, DomenicoSilvestri, ElenaCenci, CaterinaEmmi, GiacomoBiolo, GianniGuarnieri, GianfrancoZanetti, MichelaFernandes, GiovanniChiuch, MassimilianoVanoli, MassimoGrignani, GiuliaCasella, GianlucaPulixi, Edoardo AlessandroBernardi, MauroBassi, Silvia LiSanti, LucaZaccherini, GiacomoMannarino, ElmoLupattelli, GrazianaBianconi, VanessaPaciullo, FrancescoNuti, RanuccioValenti, RobertoRuvio, MartinaCappelli, SilviaPalazzuoli, AlbertoSalvatore, TeresaSasso, Ferdinando CarloGirelli, DomenicoOlivieri, OlivieroMatteazzi, ThomasBarbagallo, MarioPlances, LidiaAlcamo, RobertaLicata, GiuseppeCalvo, LuigiValenti, MariaPasini, Franco LaghiCapecchi, Pier LeopoldoBicchi, MaurizioPalasciano, GiuseppeModeo, Maria EsterPeragine, MariaPappagallo, FabrizioPugliese, StefaniaDi Gennaro, CarlaPostiglione, AlfredoBarbella, Maria RosariaDe Stefano, FrancescoCappellini, Maria DomenicaFabio, GiovannaSeghezzi, SoniaDe Amicis, Margherita MigoneMancarella, MartaMari, DanielaRossi, Paolo DionigiDamanti, SarahOttolini, Barbara BrignoloBonini, GiuliaCorazza, Gino RobertoMiceli, EmanuelaLenti, Marco VincenzoPadula, DonatellaMurialdo, GiovanniMarra, AlessioCattaneo, FedericoSecchi, Maria BeatriceGhelfi, DavideAnastasio, LuigiSofia, LuciaCarbone, MariaDavì, GiovanniGuagnano, Maria TeresaSestili, SimonaMancuso, GerardoCalipari, DanielaBartone, MosèMeroni, Maria RachelePerin, Paolo CavalloLorenzati, BartolomeoGruden, GabriellaBruno, GraziellaAmione, CristinaFornengo, PaoloTassara, RodolfoMelis, DeborahRebella, LaraDelitala, GiuseppePretti, VincenzoMasala, Maristella SalvatoraPes, ChiaraBolondi, LuigiRasciti, LeonardoSerio, IlariaFanelli, Filippo RossiAmoroso, AntonioMolfino, AlessioPetrillo, EnricoZuccalà, GiuseppeFranceschi, FrancescoDe Marco, GuidoChiara, CordischiMarta, SabbatiniD’Aurizio, GabriellaRomanelli, GiuseppeAmolini, ClaudiaChiesa, DeborahMarengoni, AlessandraPicardi, AntonioGentilucci, Umberto VespasianiGallo, PaoloAnnoni, GiorgioCorsi, MaurizioZazzetta, SaraBellelli, GiuseppeSzabo, HajnalkaArturi, FrancoSuccurro, ElenaRubino, MariangelaSesti, GiorgioLoria, PaolaBecchi, Maria AngelaMartucci, GianfrancoFantuzzi, AlessandraMaurantonio, MauroSerra, Maria GraziaBleve, Maria AntoniettaGasbarrone, LauraSajeva, Maria RosariaBrucato, AntonioGhidoni, SilviaDi Corato, PaolaAgnelli, GiancarloMarchesini, EmanuelaFabris, FabrizioCarlon, MichelaTuratto, FrancescaBaritusso, AldoTuratto, FrancescaAmabile, AnnalisaOmenetto, ElisabettaScarinzi, PaoloManfredini, RobertoMolino, ChristianPala, MarcoFabbian, FabioBoari, BenedettaDe Giorgi, AlfredoPaolisso, GiuseppeRizzo, Maria RosariaLaieta, Maria TeresaRini, GiovanbattistaMansueto, PasqualePepe, IleniaBorghi, ClaudioStrocchi, EnricoDe Sando, ValeriaPareo, IlariaSabbà, CarloVella, Francesco SaverioSuppressa, PatriziaValerio, RaffaellaAgosti, PasqualeFontana, FlaviaLoparco, FrancescaPugliese, StefaniaCapobianco, CaterinaFenoglio, LuigiBracco, ChristianGiraudo, Alessia ValentinaTesta, ElisaSerraino, CristinaFargion, SilviaBonara, PaolaPeriti, GiuliaPorzio, MariannaTiraboschi, SliviaPeyvandi, FloraTedeschi, AlbertoRossio, RaffaellaFerrari, BarbaraMonzani, ValterSavojardo, ValeriaFolli, ChristianSalerno, Maria Magnini FrancescoConca, AlessioGobbo, GiuliaConca, AlessioPallini, GiadaValenti, MiriamBalduini, Carlo L.Bertolino, GiampieraProvini, StellaQuaglia, FedericaDallegri, FrancoOttonello, LucianoLiberale, LucaChin, Wu ShengCarassale, LauraCaporotundo, SilviaTraisci, GiancarloDe Feudis, LucreziaDi Carlo, SilviaLiberato, Nicola LucioBuratti, AlbertoTognin, TizianaBianchi, Giovanni BattistaGiaquinto, SabrinaPurrello, FrancescoDi Pino, AntoninoPiro, SalvatoreRozzini, RenzoFalanga, LinaSpazzini, ElenaMontrucchio, GiuseppeGreco, ElisabettaTizzani, PietroPetitti, PaoloPerciccante, AntonioCoralli, AlessiaSalmi, RaffaellaGaudenzi, PiergiorgioGamberini, SusannaSemplicini, AndreaGottardo, LuciaVendemiale, GianluigiServiddio, GaetanoForlano, RobertaMasala, CesareMammarella, AntonioRaparelli, ValeriaVioli, FrancescoBasili, StefaniaPerri, LudovicaLandolfi, RaffaeleMontalto, MassimoMirijello, AntonioVallone, CarlaBellusci, MartinoSetti, DonatellaPedrazzoli, FilippoGuasti, LuiginaCastiglioni, LuanaMaresca, AndreaSquizzato, AlessandroMolaro, MartaBertolotti, MarcoMussi, ChiaraLibbra, Maria VittoriaMiceli, AndreaPellegrini, ElisaCarulli, LuciaVeltri, FrancescaPerticone, FrancescoSciacqua, AngelaQuero, MicheleBagnato, ChiaraColangelo, LidiaFalbo, TaniaDe Giorgio, RobertoSerra, MauroGrasso, ValentinaRuggeri, EugenioIlaria, BenzoniSalvi, AndreaLeonardi, RobertoGrassini, ChiaraMascherona, IleniaMinelli, GiorgioMaltese, FrancescaDamiani, GiampaoloCapeci, WilliamMattioli, MassimoMartino, Giuseppe PioBiondi, LorenzoOrmas, MonicaPettinari, PietroRomiti, RobertoCorrao, SalvatoreMessina, SilviaCavallaro, FedericaGhio, RiccardiFavorini, SerenaCol, Anna DalMinisola, SalvatoreColangelo, LucianoAfeltra, AntonellaAlemanno, PamelaMarigliano, BenedettaPipita, Maria ElenaCastellino, PietroBlanco, JulienZanoli, LucaCattaneo, MarcoFracasso, PaolaAmoruso, Maria ValentinaSaracco, ValterFogliati, MarisaBussolino, CarloDurante, VittorioEusebi, GiovannaTirotta, DanielaMete, FrancescaGino, MiriamCittadini, AntonioVigorito, CarloArcopinto, MicheleSalzano, AndreaBobbio, EmanueleMarra, Alberto MariaSirico, DomenicoMoreo, GuidoScopelliti, FrancescoGasparini, FrancescaCocca, MelissaBallestrero, AlbertoFerrando, FabioBerra, SergioDassi, SimonettaNava, Maria CristinaGraziella, BrunoGhidoni, SilviaAmione, CristinaBaldassarre, StefanoFragapani, SalvatoreGruden, GabriellaGalanti, GiorgioMascherini, GabrielePetri, CristianStefani, LauraGirino, MargheritaPiccinelli, ValeriaNasso, FrancescoGioffrè, VincenzaPasquale, MariaScattolin, GiuseppeMartinelli, SergioTurrin, MauroSechi, LeonardoCatena, CristinaColussi, GianlucaNieves, Ramirez DuqueAlberto, Muela MolineroPedro, Abad RequejoVanessa, Lopez PelaezLara, TamargoXavier, Corbella VirosFrancesc, FormigaJesus, Diez ManglanoEsperanza, Bejarano TelloEsther, Del Corral BehamonteMaria, Sevil PurasRomero, ManuelBlanca, Pinilla LlorenteCristina, Lopez Gonzalez-CobosVictoria, Villalba Garcia M.Saez, LopezBosco, JuanSusana, Sanz BaenaMarta, Arroyo GallegoConcepcion, Gonzalez BecerraAntonio, Fernandez MoyanoHernandez, Mercedes GomezBorrego, Manuel PoyatoRaquel, Pacheco CuadrosFlorencia, Perez RojasBeatriz, Garcia OlidSara, Carrascosa GarciaAlfonso, Gonzalez-Cruz CervelleraMarta, Peinado MartinezGarcia, Sara CarrascosaAlberto, Ruiz CanteroAntonio, Albarracín ArraigosaMontserrat, Godoy GuerreroÁngel, Barón Ramos MiguelManuel, Machin JoseIgnacio, Novo VeleiroLucía, Alvela SuarezAlfonso, LopezDavid, Rubal BranIria, Iñiguez VazquezMonica, Rios PregoOn behalf of REPOSI Investigators
Source
Drugs & Aging. April 2017 34(4):311-319
Subject
Language
English
ISSN
1170-229X
1179-1969
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.