Temporal trends in the utilization of preventive medicines by older people: A 9-year population-based study
Sujita W Narayan, June Tordoff and Prasad S Nishtala
University of Otago, New Zealand
: J Pharm Drug Deliv Res
Abstract
Preventive medicines are beneficial for disease-specific management. For older people with multi-morbidity the appropriateness of prescribing these medicines is challenging. We investigated the prevalence and temporal trends in the utilisation of preventive medicines in older New Zealanders from 2005–2013 stratified according to age, sex, ethnicity and district health board domicile. A repeated cross-sectional analysis was conducted on pharmaceutical dispensing data for individuals’ ≥65 years. Variable medication possession ratio (VMPR) for all individuals was calculated by aggregating days’ supply from the first to the last prescription divided by time between the last prescription date plus days’ supply and the first prescription date. Low-dose aspirin, clopidogrel, dipyridamole, warfarin, dabigatran, statins and bisphosphonates with a VMPR ≥0.8 were examined. The results highlighted an increase in the utilisation of aspirin by 19.55% (95% CI: 19.39 to 19.70) and clopidogrel by 2.93% (95% CI: 2.88 to 2.97). Utilisation of dipyridamole decreased by 0.65% (95% CI -0.70 to -0.59). Warfarin use decreased by 0.87% (95% CI: -0.96 to -0.78), in contrast, dabigatran increased by 0.65% (95% CI: 0.60 to 0.70). Statin use increased by 7.0% (95% CI: 6.82 to 7.18) and bisphosphonates decreased by 2.37% (95% CI: -2.44 to -2.30). Utilisation of aspirin, clopidogrel, dabigatran and statins showed a greater increase in males. Interestingly, clopidogrel, warfarin and statins use increased in older adults ≥85 years compared to younger age groups (65-84 years). The results presented in this study may facilitate further research to examine the appropriateness of prescribing these medicines in older people with multi-morbidity.
Biography
Email: sujita.narayan@otago.ac.nz
