TY - JOUR
T1 - The changing pattern of statin use in people with dementia
T2 - A population-based study
AU - Picton, Leonie
AU - Bell, J. Simon
AU - George, Johnson
AU - Korhonen, Maarit Jaana
AU - Ilomäki, Jenni
PY - 2021/1/1
Y1 - 2021/1/1
N2 - Background: After a dementia diagnosis, goals of care are often reassessed, including the use of preventive medications like statins. Objective: To examine changes in statin use after initiating medication for managing dementia. Methods: A case-crossover study utilizing medication dispensing data from the Australian Pharmaceutical Benefits Scheme (PBS) 10% random sample was conducted. Use of statins was compared in the 12 months pre- and post-initiation (pre-period and post-period) of anti-dementia medications or risperidone for behavioural symptoms of dementia. Individuals aged ≥65 years who had their first dispensing of anti-dementia medication or risperidone between July 2006 and June 2017 and survived ≥12 months after their first supply were included. Conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for change in statin use in the discordant pairs. Results: The cohort (n = 19,809) had a median age of 81 years and 61% were female. Statins were less likely to be used after initiating anti-dementia medication or risperidone (OR 0.50; 95%CI 0.45–0.55). The OR for statin use in the post-period versus the pre-period decreased annually over the 11 years from 1.21; 95%CI 0.84–1.75 in 2006–7 to 0.31; 95%CI 0.24–0.41 in 2016–17 (p for interaction <0.05). Conclusion: Statins are more likely to be ceased than started after initiating medication for dementia. This may reflect changes in goals of care, or changes in the interpretation of the available evidence for the safety and efficacy of statins in older people living with dementia.
AB - Background: After a dementia diagnosis, goals of care are often reassessed, including the use of preventive medications like statins. Objective: To examine changes in statin use after initiating medication for managing dementia. Methods: A case-crossover study utilizing medication dispensing data from the Australian Pharmaceutical Benefits Scheme (PBS) 10% random sample was conducted. Use of statins was compared in the 12 months pre- and post-initiation (pre-period and post-period) of anti-dementia medications or risperidone for behavioural symptoms of dementia. Individuals aged ≥65 years who had their first dispensing of anti-dementia medication or risperidone between July 2006 and June 2017 and survived ≥12 months after their first supply were included. Conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for change in statin use in the discordant pairs. Results: The cohort (n = 19,809) had a median age of 81 years and 61% were female. Statins were less likely to be used after initiating anti-dementia medication or risperidone (OR 0.50; 95%CI 0.45–0.55). The OR for statin use in the post-period versus the pre-period decreased annually over the 11 years from 1.21; 95%CI 0.84–1.75 in 2006–7 to 0.31; 95%CI 0.24–0.41 in 2016–17 (p for interaction <0.05). Conclusion: Statins are more likely to be ceased than started after initiating medication for dementia. This may reflect changes in goals of care, or changes in the interpretation of the available evidence for the safety and efficacy of statins in older people living with dementia.
KW - Australia
KW - Dementia
KW - Drug utilization
KW - Statins
UR - http://www.scopus.com/inward/record.url?scp=85097753878&partnerID=8YFLogxK
U2 - 10.1016/j.jacl.2020.11.008
DO - 10.1016/j.jacl.2020.11.008
M3 - Article
C2 - 33309941
AN - SCOPUS:85097753878
SN - 1933-2874
VL - 15
SP - 192
EP - 201
JO - Journal of Clinical Lipidology
JF - Journal of Clinical Lipidology
IS - 1
ER -