Evidence map›Paper›PMID 26683286›Full record

Observational studyScandinavian journal of primary health care2015

Drug prescription rates in secondary cardiovascular prevention in old age: Do vulnerability and severity of the history of cardiovascular disease matter?

Petra G van Peet, Jacobijn Gussekloo, Wendy P J den Elzen, Jeanet W Blom, Margot W M de Waal, Wouter de Ruijter

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Scandinavian journal of primary health care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.2field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Petra G van Peeta Department of Public Health and Primary Care , Leiden University Medical Center , Leiden , The Netherlands.
Jacobijn Gusseklooa Department of Public Health and Primary Care , Leiden University Medical Center , Leiden , The Netherlands.
Wendy P J den Elzena Department of Public Health and Primary Care , Leiden University Medical Center , Leiden , The Netherlands.
Jeanet W Bloma Department of Public Health and Primary Care , Leiden University Medical Center , Leiden , The Netherlands.
Margot W M de Waala Department of Public Health and Primary Care , Leiden University Medical Center , Leiden , The Netherlands.
Wouter de Ruijtera Department of Public Health and Primary Care , Leiden University Medical Center , Leiden , The Netherlands.
Leiden University Medical Center · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess the influence vulnerability and severity of cardiovascular disease (CVD), on prescription rates of secondary cardiovascular preventive drugs in old age.

designPopulation-based observational study within the ISCOPE study.

settingGeneral practices in the Netherlands. SUBJECTS: A total of 1350 patients with a history of CVD (median age 81 years, 50% female).

main outcome measuresOne-year prescription rates of lipid-lowering drugs and antithrombotics were obtained from the electronic medical records of 46 general practitioners (GPs). Prescription of both drugs for ≥ 270 days per year was considered optimal. GPs made a judgement of vulnerability. Severity of CVD was expressed as major (myocardial infarction, stroke, or arterial surgery) versus minor (angina, transient ischaemic attack, or claudication).

resultsGPs considered 411 (30%) participants to be vulnerable and 619 (55%) participants had major CVD. Optimal treatment was prescribed to 680 (50%) participants, whereas 370 (27%) received an antithrombotic drug only, 53 (4%) a lipid-lowering drug only, and 247 (18%) received neither. Optimal treatment was lower in participants aged ≥ 85 years (OR 0.37 [95% CI 0.29-0.48]), in females (OR 0.63 [0.50-0.78]), in vulnerable persons (OR 0.79 [0.62-0.99]) and in participants with minor CVD (OR 0.65 [0.53-0.81]). Multivariate ORs remained similar whereas vulnerability lost its significance (OR 0.88 [0.69-1.1]).

conclusionIn old age, GPs' judgement of vulnerability is not independently associated with lower treatment rates of both lipid-lowering drugs and antithrombotics, whereas a history of minor CVD is. Individual proactive re-evaluation of preventive treatment in older (female) patients, especially those with a history of minor CVD, is recommended. Key points Prescriptions of lipid-lowering drugs and antithrombotics in secondary cardiovascular prevention tend to decline with age. In this study with median age 81 years, 50% of participants received optimal treatment with both lipid-lowering drugs and antithrombotics. GPs' judgement of vulnerability was not independently associated with optimal treatment. A history of less severe cardiovascular disease was independently associated with lower prescription rates of lipid-lowering drugs and antithrombotics. Proactive individual re-evaluation of cardiovascular preventive treatment in older (female) patients, especially patients with less severe cardiovascular disease, is recommended.

Indexed as

AgedAged, 80 and overAnticoagulantsCardiovascular DiseasesDrug PrescriptionsFamily PracticeFemaleFibrinolytic AgentsHealth StatusHumansHypolipidemic AgentsMaleMultivariate AnalysisNetherlandsPractice Patterns, Physicians'Precision MedicineAnticoagulantsFibrinolytic AgentsHypolipidemic AgentsCardiovascular diseasesdrug prescriptionsgeneral practiceold agesecondary preventionthe Netherlandsvulnerability

Identifiers

PMID26683286
PMCPMC4750735
OpenAlexW2278849387

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.