1 Centre of cardiovascular Research and Education in therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
2 Epidemiological Modelling Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Am J Alzheimers Dis Other Demen. 2018 Dec;33(8):527-534. doi: 10.1177/1533317518787314. Epub 2018 Jul 10.
To examine the patterns of statin use and determine the 3-year adherence and discontinuation rates among a cohort of Australians aged ≥65 years with dementia.
The yearly prevalence and incidence of statin use were compared via Poisson regression modeling using 2007 as the reference year. People with dementia were identified according to dispensing of antidementia medications. A cohort of 589 new statin users was followed longitudinally. Adherence was estimated via the proportion of days covered (PDC). Discontinuation was defined as ≥90 days without statin coverage.
The annual prevalence of statin use among older Australians with dementia increased from 20.6% in 2007 to 31.7% in 2016 (aged-sex adjusted rate ratio: 1.51, 95% confidence interval: 1.35-1.69). Among the new users, the proportion adherent (PDC ≥ 0.80) decreased from 60.3% at 6 months to 31.0% at 3 years. During the 3-year follow-up, 58.7% discontinued their statin.
Despite increased use of statins among older Australians with dementia, adherence is low and discontinuation is high, which may point to intentional cessation.
考察澳大利亚≥65 岁痴呆患者他汀类药物的使用模式，并确定其 3 年的依从性和停药率。
采用泊松回归模型比较每年他汀类药物的使用率，以 2007 年为参考年。根据抗痴呆药物的配药情况来确定痴呆患者。对 589 名新使用他汀类药物的患者进行纵向随访。通过覆盖天数比例（PDC）来评估依从性。停药定义为≥90 天无他汀类药物覆盖。
在 2007 年至 2016 年期间，澳大利亚≥65 岁痴呆患者中他汀类药物的年使用率从 20.6%增加到 31.7%（年龄性别调整率比：1.51，95%置信区间：1.35-1.69）。在新使用者中，6 个月时的依从率（PDC≥0.80）为 60.3%，3 年时降至 31.0%。在 3 年的随访期间，58.7%的患者停止使用他汀类药物。
尽管澳大利亚≥65 岁痴呆患者中他汀类药物的使用有所增加，但依从性低，停药率高，这可能表明是有意停药。
