Temporal trends in the utilisation of preventive medicines by older people: A 9-year population-based study

Sujita W. Narayan, June M. Tordoff, Prasad S. Nishtala

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Abstract

Background: For older individuals with multimorbidity the appropriateness of prescribing preventive medicines remains a challenge. Objective: Investigate the prevalence and temporal trends in utilisation of preventive medicines in older New Zealanders from 2005 to 2013 stratified according to age, sex, ethnicity and district health board domicile. Methods: A repeated cross-sectional analysis was conducted on pharmaceutical dispensing data for all individuals' ≥65 years. Variable medication possession ratio (VMPR) was used to measure adherence. Prescribing of low-dose aspirin, clopidogrel, dipyridamole, warfarin, dabigatran, statins and bisphosphonates with a VMPR. ≥. 0.8 were examined. Results: Aspirin utilisation increased by 19.55% (95% CI: 19.39-19.70), clopidogrel by 2.93% (95% CI: 2.88-2.97) and dipyridamole decreased by 0.65% (95% CI: -0.70 to -0.59). Utilisation of aspirin with clopidogrel increased by 1.78% (95% CI: 1.74-1.81) and aspirin with dipyridamole increased by 0.54% (95% CI: 0.50-0.58%).Warfarin decreased by 0.87% (95% CI: -0.96 to -0.78) and dabigatran increased by 0.65% (95% CI: 0.60-0.70). Statins increased by 7.0% (95% CI: 6.82-7.18) and bisphosphonates decreased by 2.37% (95% CI: -2.44 to -2.30). Aspirin, clopidogrel, dabigatran and statins utilisation showed a greater increase in males. Interestingly, clopidogrel, warfarin and statins use increased in older adults aged 85+ compared to the younger age groups (65-84 years). Conclusion: To our knowledge, this is the first study investigating the prevalence and trends of preventive medicines use in older people in New Zealand. This study may facilitate further research to examine the appropriateness of prescribing these medicines in older people with multimorbidity.

Original languageEnglish
Pages (from-to)103-111
Number of pages9
JournalArchives of Gerontology and Geriatrics
Volume62
DOIs
Publication statusPublished - 1 Jan 2016

Funding

The authors would like to thank the Analytical Services, Ministry of Health of New Zealand for supplying the prescription data extracted from the Pharms database. Sujita. W. Narayan was funded by a doctoral scholarship from the School of Pharmacy, University of Otago, New Zealand. There are no conflicts of interest that are directly relevant to the content of the study. The manuscript does not contain clinical studies and all patient data are de-identified.

Keywords

  • Antithrombotics
  • Bisphosphonates
  • Older people
  • Preventive medicines
  • Statins

ASJC Scopus subject areas

  • Health(social science)
  • Ageing
  • Gerontology
  • Geriatrics and Gerontology

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