丹麦 70 岁及以上人群中他汀类药物的使用和停药情况:一项全国性药物利用研究。
Statin use and discontinuation in Danes age 70 and older: a nationwide drug utilisation study.
机构信息
Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Denmark.
Hospital Pharmacy Funen, Odense University Hospital, Odense, Denmark.
出版信息
Age Ageing. 2021 Feb 26;50(2):554-558. doi: 10.1093/ageing/afaa160.
BACKGROUND AND OBJECTIVE
There is limited evidence on the clinical effects of statins in older persons. We aimed to explore statin use and discontinuation patterns in Danes age 70 and older.
DESIGN
Register-based drug utilisation study.
SETTING
Danish nationwide health registries.
SUBJECTS
All Danish persons aged ≥70 years between 2011 and 2016.
MEASUREMENTS
(1) Monthly prevalence and (2) quarterly incidence of statin use, (3) characteristics of new users, (4) total amount of statin redeemed, (5) statin discontinuation rate between 2014 and 2016 in long-term statin users and (6) factors associated with discontinuation.
RESULTS
We identified 395,279 unique older statin users between 2011 and 2016. The prevalence increased from 30% in 2011 to 33% in 2016 (23% for primary prevention and 56% for secondary prevention in 2016). The quarterly incidence fell from 11 per 1,000 persons in 2011 to 7 per 1,000 persons in 2016. The prevalence was generally stable in those 70 to 79 years. In those aged ≥80 years, the prevalence increased despite decreasing incidence. The proportion of persons initiating for primary prevention decreased from 58% in 2011 to 52% in 2016. Approximately 19% of long-term statin users discontinued therapy between 2014 and 2016. Increasing age was the strongest predictor of statin discontinuation.
CONCLUSIONS
Approximately one in three Danes age ≥ 70 years were taking statins in 2016. The characteristics of incident users shifted between 2011 and 2016, with less people age 80 and older starting on statins and fewer people starting for primary prevention.
背景和目的
关于他汀类药物在老年人中的临床效果,证据有限。我们旨在探讨丹麦 70 岁及以上人群中他汀类药物的使用和停药模式。
设计
基于注册的药物使用研究。
设置
丹麦全国性健康登记处。
受试者
2011 年至 2016 年间所有年龄≥70 岁的丹麦人。
测量
(1)每月流行率和(2)2014 年至 2016 年期间他汀类药物的季度发生率,(3)新使用者的特征,(4)他汀类药物的总使用量,(5)长期使用他汀类药物的患者在 2014 年至 2016 年期间的停药率,(6)与停药相关的因素。
结果
我们在 2011 年至 2016 年间确定了 395279 名独特的老年他汀类药物使用者。流行率从 2011 年的 30%上升到 2016 年的 33%(2016 年一级预防为 23%,二级预防为 56%)。季度发生率从 2011 年的每千人 11 人降至 2016 年的每千人 7 人。70 至 79 岁的患者中,流行率基本保持稳定。≥80 岁的患者中,尽管发生率下降,但流行率仍有所上升。2011 年一级预防起始比例为 58%,2016 年降至 52%。2014 年至 2016 年间,约有 19%的长期使用他汀类药物的患者停止治疗。年龄增长是他汀类药物停药的最强预测因素。
结论
2016 年,约有 1/3 的丹麦≥70 岁人群服用他汀类药物。2011 年至 2016 年间,新使用者的特征发生了变化,80 岁及以上人群开始使用他汀类药物的人数减少,开始用于一级预防的人数也减少。