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Drugs Aging. 2017 Apr;34(4):311-319. doi: 10.1007/s40266-017-0448-8.

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.

Collaborators (402)

Mannucci PM, Nobili A, Tettamanti M, Pasina L, Franchi C, Perticone F, Salerno F, Corrao S, Marengoni A, Licata G, Violi F, Corazza GR, Marcucci M, Eldin TK, Di Blanca MP, Lanzo G, Astuto S, Tettamanti M, Ardoino I, Cortesi L, Prisco D, Silvestri E, Cenci C, Emmi G, Biolo G, Guarnieri G, Zanetti M, Fernandes G, Chiuch M, Vanoli M, Grignani G, Casella G, Pulixi EA, Bernardi M, Bassi SL, Santi L, Zaccherini G, Mannarino E, Lupattelli G, Bianconi V, Paciullo F, Nuti R, Valenti R, Ruvio M, Cappelli S, Palazzuoli A, Salvatore T, Sasso FC, Girelli D, Olivieri O, Matteazzi T, Barbagallo M, Plances L, Alcamo R, Licata G, Calvo L, Valenti M, Pasini FL, Capecchi PL, Bicchi M, Palasciano G, Modeo ME, Peragine M, Pappagallo F, Pugliese S, Di Gennaro C, Postiglione A, Barbella MR, De Stefano F, Cappellini MD, Fabio G, Seghezzi S, De Amicis MM, Mancarella M, Mari D, Rossi PD, Damanti S, Ottolini BB, Bonini G, Corazza GR, Miceli E, Lenti MV, Padula D, Murialdo G, Marra A, Cattaneo F, Secchi MB, Ghelfi D, Anastasio L, Sofia L, Carbone M, Davì G, Guagnano MT, Sestili S, Mancuso G, Calipari D, Bartone M, Meroni MR, Perin PC, Lorenzati B, Gruden G, Bruno G, Amione C, Fornengo P, Tassara R, Melis D, Rebella L, Delitala G, Pretti V, Masala MS, Pes C, Bolondi L, Rasciti L, Serio I, Fanelli FR, Amoroso A, Molfino A, Petrillo E, Zuccalà G, Franceschi F, De Marco G, Chiara C, Marta S, D'Aurizio G, Romanelli G, Amolini C, Chiesa D, Marengoni A, Picardi A, Gentilucci UV, Gallo P, Annoni G, Corsi M, Zazzetta S, Bellelli G, Szabo H, Arturi F, Succurro E, Rubino M, Sesti G, Loria P, Becchi MA, Martucci G, Fantuzzi A, Maurantonio M, Serra MG, Bleve MA, Gasbarrone L, Sajeva MR, Brucato A, Ghidoni S, Di Corato P, Agnelli G, Marchesini E, Fabris F, Carlon M, Turatto F, Baritusso A, Turatto F, Amabile A, Omenetto E, Scarinzi P, Manfredini R, Molino C, Pala M, Fabbian F, Boari B, De Giorgi A, Paolisso G, Rizzo MR, Laieta MT, Rini G, Mansueto P, Pepe I, Borghi C, Strocchi E, De Sando V, Pareo I, Sabbà C, Vella FS, Suppressa P, Valerio R, Agosti P, Fontana F, Loparco F, Pugliese S, Capobianco C, Fenoglio L, Bracco C, Giraudo AV, Testa E, Serraino C, Fargion S, Bonara P, Periti G, Porzio M, Tiraboschi S, Peyvandi F, Tedeschi A, Rossio R, Ferrari B, Monzani V, Savojardo V, Folli C, Salerno MM, Conca A, Gobbo G, Conca A, Pallini G, Valenti M, Balduini CL, Bertolino G, Provini S, Quaglia F, Dallegri F, Ottonello L, Liberale L, Chin WS, Carassale L, Caporotundo S, Traisci G, De Feudis L, Di Carlo S, Liberato NL, Buratti A, Tognin T, Bianchi GB, Giaquinto S, Purrello F, Di Pino A, Piro S, Rozzini R, Falanga L, Spazzini E, Montrucchio G, Greco E, Tizzani P, Petitti P, Perciccante A, Coralli A, Salmi R, Gaudenzi P, Gamberini S, Semplicini A, Gottardo L, Vendemiale G, Serviddio G, Forlano R, Masala C, Mammarella A, Raparelli V, Violi F, Basili S, Perri L, Landolfi R, Montalto M, Mirijello A, Vallone C, Bellusci M, Setti D, Pedrazzoli F, Guasti L, Castiglioni L, Maresca A, Squizzato A, Molaro M, Bertolotti M, Mussi C, Libbra MV, Miceli A, Pellegrini E, Carulli L, Veltri F, Perticone F, Sciacqua A, Quero M, Bagnato C, Colangelo L, Falbo T, De Giorgio R, Serra M, Grasso V, Ruggeri E, Ilaria B, Salvi A, Leonardi R, Grassini C, Mascherona I, Minelli G, Maltese F, Damiani G, Capeci W, Mattioli M, Martino GP, Biondi L, Ormas M, Pettinari P, Romiti R, Corrao S, Messina S, Cavallaro F, Ghio R, Favorini S, Col AD, Minisola S, Colangelo L, Afeltra A, Alemanno P, Marigliano B, Pipita ME, Castellino P, Blanco J, Zanoli L, Cattaneo M, Fracasso P, Amoruso MV, Saracco V, Fogliati M, Bussolino C, Durante V, Eusebi G, Tirotta D, Mete F, Gino M, Cittadini A, Vigorito C, Arcopinto M, Salzano A, Bobbio E, Marra AM, Sirico D, Moreo G, Scopelliti F, Gasparini F, Cocca M, Ballestrero A, Ferrando F, Berra S, Dassi S, Nava MC, Graziella B, Ghidoni S, Amione C, Baldassarre S, Fragapani S, Gruden G, Galanti G, Mascherini G, Petri C, Stefani L, Girino M, Piccinelli V, Nasso F, Gioffrè V, Pasquale M, Scattolin G, Martinelli S, Turrin M, Sechi L, Catena C, Colussi G, Nieves RD, Alberto MM, Pedro AR, Vanessa LP, Lara T, Xavier CV, Francesc F, Jesus DM, Esperanza BT, Esther DC, Maria SP, Romero M, Blanca PL, Cristina LG, Victoria VG, Saez L, Bosco J, Susana SB, Marta AG, Concepcion GB, Antonio FM, Hernandez MG, Borrego MP, Raquel PC, Florencia PR, Beatriz GO, Sara CG, Alfonso GC, Marta PM, Garcia SC, Alberto RC, Antonio AA, Montserrat GG, Ángel BR, Manuel MJ, Ignacio NV, Lucía AS, Alfonso L, David RB, Iria IV, Monica RP.

Author information

1
Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy. marco.bertolotti@unimore.it.
2
Dipartimento Integrato di Medicina, Endocrinologia, Metabolismo e Geriatria, Azienda Ospedaliero-Universitaria di Modena, Nuovo Ospedale Civile, via Giardini 1355, 41126, Modena, Italy. marco.bertolotti@unimore.it.
3
IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milano, Italy.
4
Department of Biomolecular Sciences, University of Urbino, Urbino, Italy.
5
Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
6
Dipartimento Integrato di Medicina, Endocrinologia, Metabolismo e Geriatria, Azienda Ospedaliero-Universitaria di Modena, Nuovo Ospedale Civile, via Giardini 1355, 41126, Modena, Italy.

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.

PMID:
28299634
DOI:
10.1007/s40266-017-0448-8
[Indexed for MEDLINE]

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