Predictors of statin use among older adults: A nationwide cross-sectional study

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Statins comprise a key strategy for the prevention and treatment of arteriosclerotic cardiovascular disease, but prescribing remains suboptimal. Objectives: The objective of this study was to characterize the predictors of statin use among adults aged ≥65 years. Methods: A cross-sectional study using Pharmaceutical Benefits Scheme (PBS) data on reimbursed prescriptions for a 10% random sample of the Australian population in 2016 was performed. Predictors of statin use were identified via multivariable logistic regression. Analyses were performed separately for people who were concessional beneficiaries (with a low, capped copayment) and other (“general”) people. Results: Among 351,471 (concessional = 295,875 and general = 55,596) older adults, 44.2% were dispensed statins (concessional = 46.4% and general = 32.2%). Among the concessional beneficiaries, people aged 75 to 84 years were more likely to use statins (odds ratio [OR] 1.08, 95% confidence interval [CI] 1.06–1.10), whereas those aged ≥85 years were less likely to use statins (OR 0.71, 95% CI 0.69–0.72), compared with people aged 65 to 74 years. Men were more likely to use statins than women (OR 1.14, 95% CI 1.12–1.16). Diabetes was associated with over 2-fold (OR 2.48, 95% CI 2.43–2.53) increased likelihood of statin use. People with cardiovascular-related conditions including hypertension, angina, and congestive heart failure experienced increased likelihood of statin use as was being dispensed anticoagulant or antiplatelet medication. Having malignancy, psychotic illness, or pain were associated with lower likelihood of statin use. Similar predictors of statin use were noted for the general population. Conclusion: More than 40% of older adults in Australia used statins in 2016 with uptake dependent on individual-level factors such as demographics and comorbidities. Future research should examine the extent to which provider and/or health system–level factors contribute to the variable uptake of statin therapy.

Original languageEnglish
Pages (from-to)156-162
Number of pages7
JournalJournal of Clinical Lipidology
Volume13
Issue number1
DOIs
Publication statusPublished - Feb 2019

Keywords

  • Cholesterol treatment
  • HMG-CoA reductase inhibitors
  • Older adults
  • Predictors
  • Prescribing

Cite this

@article{e92260ae126d400196e3746d0c5a073a,
title = "Predictors of statin use among older adults: A nationwide cross-sectional study",
abstract = "Background: Statins comprise a key strategy for the prevention and treatment of arteriosclerotic cardiovascular disease, but prescribing remains suboptimal. Objectives: The objective of this study was to characterize the predictors of statin use among adults aged ≥65 years. Methods: A cross-sectional study using Pharmaceutical Benefits Scheme (PBS) data on reimbursed prescriptions for a 10{\%} random sample of the Australian population in 2016 was performed. Predictors of statin use were identified via multivariable logistic regression. Analyses were performed separately for people who were concessional beneficiaries (with a low, capped copayment) and other (“general”) people. Results: Among 351,471 (concessional = 295,875 and general = 55,596) older adults, 44.2{\%} were dispensed statins (concessional = 46.4{\%} and general = 32.2{\%}). Among the concessional beneficiaries, people aged 75 to 84 years were more likely to use statins (odds ratio [OR] 1.08, 95{\%} confidence interval [CI] 1.06–1.10), whereas those aged ≥85 years were less likely to use statins (OR 0.71, 95{\%} CI 0.69–0.72), compared with people aged 65 to 74 years. Men were more likely to use statins than women (OR 1.14, 95{\%} CI 1.12–1.16). Diabetes was associated with over 2-fold (OR 2.48, 95{\%} CI 2.43–2.53) increased likelihood of statin use. People with cardiovascular-related conditions including hypertension, angina, and congestive heart failure experienced increased likelihood of statin use as was being dispensed anticoagulant or antiplatelet medication. Having malignancy, psychotic illness, or pain were associated with lower likelihood of statin use. Similar predictors of statin use were noted for the general population. Conclusion: More than 40{\%} of older adults in Australia used statins in 2016 with uptake dependent on individual-level factors such as demographics and comorbidities. Future research should examine the extent to which provider and/or health system–level factors contribute to the variable uptake of statin therapy.",
keywords = "Cholesterol treatment, HMG-CoA reductase inhibitors, Older adults, Predictors, Prescribing",
author = "Richard Ofori-Asenso and Jenni Ilom{\"a}ki and Mark Tacey and Ella Zomer and Curtis, {Andrea J.} and Bell, {J. Simon} and Sophia Zoungas and Danny Liew",
year = "2019",
month = "2",
doi = "10.1016/j.jacl.2018.10.002",
language = "English",
volume = "13",
pages = "156--162",
journal = "Journal of Clinical Lipidology",
issn = "1933-2874",
publisher = "Elsevier",
number = "1",

}

Predictors of statin use among older adults : A nationwide cross-sectional study. / Ofori-Asenso, Richard; Ilomäki, Jenni; Tacey, Mark; Zomer, Ella; Curtis, Andrea J.; Bell, J. Simon; Zoungas, Sophia; Liew, Danny.

In: Journal of Clinical Lipidology, Vol. 13, No. 1, 02.2019, p. 156-162.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Predictors of statin use among older adults

T2 - A nationwide cross-sectional study

AU - Ofori-Asenso, Richard

AU - Ilomäki, Jenni

AU - Tacey, Mark

AU - Zomer, Ella

AU - Curtis, Andrea J.

AU - Bell, J. Simon

AU - Zoungas, Sophia

AU - Liew, Danny

PY - 2019/2

Y1 - 2019/2

N2 - Background: Statins comprise a key strategy for the prevention and treatment of arteriosclerotic cardiovascular disease, but prescribing remains suboptimal. Objectives: The objective of this study was to characterize the predictors of statin use among adults aged ≥65 years. Methods: A cross-sectional study using Pharmaceutical Benefits Scheme (PBS) data on reimbursed prescriptions for a 10% random sample of the Australian population in 2016 was performed. Predictors of statin use were identified via multivariable logistic regression. Analyses were performed separately for people who were concessional beneficiaries (with a low, capped copayment) and other (“general”) people. Results: Among 351,471 (concessional = 295,875 and general = 55,596) older adults, 44.2% were dispensed statins (concessional = 46.4% and general = 32.2%). Among the concessional beneficiaries, people aged 75 to 84 years were more likely to use statins (odds ratio [OR] 1.08, 95% confidence interval [CI] 1.06–1.10), whereas those aged ≥85 years were less likely to use statins (OR 0.71, 95% CI 0.69–0.72), compared with people aged 65 to 74 years. Men were more likely to use statins than women (OR 1.14, 95% CI 1.12–1.16). Diabetes was associated with over 2-fold (OR 2.48, 95% CI 2.43–2.53) increased likelihood of statin use. People with cardiovascular-related conditions including hypertension, angina, and congestive heart failure experienced increased likelihood of statin use as was being dispensed anticoagulant or antiplatelet medication. Having malignancy, psychotic illness, or pain were associated with lower likelihood of statin use. Similar predictors of statin use were noted for the general population. Conclusion: More than 40% of older adults in Australia used statins in 2016 with uptake dependent on individual-level factors such as demographics and comorbidities. Future research should examine the extent to which provider and/or health system–level factors contribute to the variable uptake of statin therapy.

AB - Background: Statins comprise a key strategy for the prevention and treatment of arteriosclerotic cardiovascular disease, but prescribing remains suboptimal. Objectives: The objective of this study was to characterize the predictors of statin use among adults aged ≥65 years. Methods: A cross-sectional study using Pharmaceutical Benefits Scheme (PBS) data on reimbursed prescriptions for a 10% random sample of the Australian population in 2016 was performed. Predictors of statin use were identified via multivariable logistic regression. Analyses were performed separately for people who were concessional beneficiaries (with a low, capped copayment) and other (“general”) people. Results: Among 351,471 (concessional = 295,875 and general = 55,596) older adults, 44.2% were dispensed statins (concessional = 46.4% and general = 32.2%). Among the concessional beneficiaries, people aged 75 to 84 years were more likely to use statins (odds ratio [OR] 1.08, 95% confidence interval [CI] 1.06–1.10), whereas those aged ≥85 years were less likely to use statins (OR 0.71, 95% CI 0.69–0.72), compared with people aged 65 to 74 years. Men were more likely to use statins than women (OR 1.14, 95% CI 1.12–1.16). Diabetes was associated with over 2-fold (OR 2.48, 95% CI 2.43–2.53) increased likelihood of statin use. People with cardiovascular-related conditions including hypertension, angina, and congestive heart failure experienced increased likelihood of statin use as was being dispensed anticoagulant or antiplatelet medication. Having malignancy, psychotic illness, or pain were associated with lower likelihood of statin use. Similar predictors of statin use were noted for the general population. Conclusion: More than 40% of older adults in Australia used statins in 2016 with uptake dependent on individual-level factors such as demographics and comorbidities. Future research should examine the extent to which provider and/or health system–level factors contribute to the variable uptake of statin therapy.

KW - Cholesterol treatment

KW - HMG-CoA reductase inhibitors

KW - Older adults

KW - Predictors

KW - Prescribing

UR - http://www.scopus.com/inward/record.url?scp=85056433534&partnerID=8YFLogxK

U2 - 10.1016/j.jacl.2018.10.002

DO - 10.1016/j.jacl.2018.10.002

M3 - Article

VL - 13

SP - 156

EP - 162

JO - Journal of Clinical Lipidology

JF - Journal of Clinical Lipidology

SN - 1933-2874

IS - 1

ER -