TY - JOUR
T1 - Guideline-based medications for older adults discharged after percutaneous coronary intervention in a suburban city of Japan
T2 - A cohort study using claims data
AU - Shimada, Koki
AU - Hamada, Shota
AU - Sawano, Mitsuaki
AU - Yamamoto, Hiroyuki
AU - Yoshie, Satoru
AU - Iijima, Katsuya
AU - Miyata, Hiroaki
N1 - Funding Information:
The authors declare no conflict of interest concerning the present study. On the other hand, K.S., H.Y., and H.M. are also affiliated with the Department of Healthcare Quality Assessment at The University of Tokyo. The department is a social collaboration department supported by grants from the National Clinical Database, Johnson & Johnson K.K., and Nipro Corporation. K.S. reports receiv-ing a portion of his salary from joint research funding by AstraZeneca K.K. of the JST-OPERA Program. M.S. received a grant from Takeda Japan Medical Office Funded Research Grant 2018 outside of the submitted work.
Funding Information:
the present study. On the other hand, K.S., H.Y., and H.M. are also affiliated with the Department of Healthcare Quality Assessment at The University of Tokyo. The department is a social collaboration department supported by grants from the National Clinical Database, Johnson & Johnson K.K., and Nipro Corporation. K.S. reports receiving a portion of his salary from joint research funding by AstraZeneca K.K. of the JST-OPERA Program. M.S. received a grant from Takeda Japan Medical Office Funded Research Grant 2018 outside of the submitted work.
Publisher Copyright:
© 2020 Tohoku University Medical Press.
PY - 2020
Y1 - 2020
N2 - Secondary prevention with medications is essential for the better prognosis of patients who have experienced cardiovascular events. We aimed to evaluate the use of guideline-based medications for secondary prevention in older adults in the community settings after discharge following percutaneous coronary intervention (PCI). A retrospective cohort study was conducted using anonymized claims data of older beneficiaries in a suburban city of Japan between April 2012 and March 2015. The prescriptions of antiplatelets, statins, angiotensin-converting enzyme inhibitors (ACEi)/angiotensin II receptor blockers (ARB), and β-blockers were evaluated for 3 months before and after the month in which the participants underwent PCI. Multivariable logistic regression analysis was conducted to evaluate the associations of age (“pre-old” group [63-72 years] vs. “old” group [≥ 73 years]) and sex with the prescriptions, adjusting for whether a participant was followed-up by the PCI-performing hospital. Of 815 participants, 59.6% constituted the old group and 70.9% were men. The prescription rates for antiplatelets, statins, ACEi/ARB, and β-blockers after discharge were 94.6%, 65.0%, 59.3%, and 32.9%, respectively. The adjusted analysis indicated that statins were less likely to be prescribed for the old group (adjusted odds ratio [aOR], 0.70; 95% confidence interval [CI], 0.51-0.95; p = 0.023) and for men (aOR, 0.64; 95% CI, 0.45-0.89; p = 0.008). β-blockers were more likely to be prescribed for men (aOR, 1.66; 95% CI, 1.17-2.33; p = 0.004). Our results suggest the potential for improvements in secondary prevention by increasing the prescription rates of guideline-based medications in this population.
AB - Secondary prevention with medications is essential for the better prognosis of patients who have experienced cardiovascular events. We aimed to evaluate the use of guideline-based medications for secondary prevention in older adults in the community settings after discharge following percutaneous coronary intervention (PCI). A retrospective cohort study was conducted using anonymized claims data of older beneficiaries in a suburban city of Japan between April 2012 and March 2015. The prescriptions of antiplatelets, statins, angiotensin-converting enzyme inhibitors (ACEi)/angiotensin II receptor blockers (ARB), and β-blockers were evaluated for 3 months before and after the month in which the participants underwent PCI. Multivariable logistic regression analysis was conducted to evaluate the associations of age (“pre-old” group [63-72 years] vs. “old” group [≥ 73 years]) and sex with the prescriptions, adjusting for whether a participant was followed-up by the PCI-performing hospital. Of 815 participants, 59.6% constituted the old group and 70.9% were men. The prescription rates for antiplatelets, statins, ACEi/ARB, and β-blockers after discharge were 94.6%, 65.0%, 59.3%, and 32.9%, respectively. The adjusted analysis indicated that statins were less likely to be prescribed for the old group (adjusted odds ratio [aOR], 0.70; 95% confidence interval [CI], 0.51-0.95; p = 0.023) and for men (aOR, 0.64; 95% CI, 0.45-0.89; p = 0.008). β-blockers were more likely to be prescribed for men (aOR, 1.66; 95% CI, 1.17-2.33; p = 0.004). Our results suggest the potential for improvements in secondary prevention by increasing the prescription rates of guideline-based medications in this population.
KW - Claims data
KW - Coronary artery disease
KW - Elderly
KW - Percutaneous coronary intervention
KW - Secondary prevention
UR - http://www.scopus.com/inward/record.url?scp=85092289907&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85092289907&partnerID=8YFLogxK
U2 - 10.1620/tjem.252.143
DO - 10.1620/tjem.252.143
M3 - Article
C2 - 33028759
AN - SCOPUS:85092289907
VL - 252
SP - 143
EP - 152
JO - Tohoku Journal of Experimental Medicine
JF - Tohoku Journal of Experimental Medicine
SN - 0040-8727
IS - 2
ER -