UNDEREXPOSURE OF SENIORS TO HEART FAILURE DRUG THERAPY

Main Article Content

Catherine Girouard
Jean-Pierre Grégoire
Jeanne-Françoise Kayibanda
Paul Poirier
Éric Demers
Jocelyne Moisan

Keywords

Heart failure, aging, evidence -based health care, drug therapy

Abstract

Background


Little is known about exposure to heart failure ( HF ) treatment among seniors with ischemic heart disease.


Objectives


In a population of seniors, we: 1) estimated the association between age and exposure to HF drug therapy at 6, 12, 36 and 60 month intervals after HF diagnosis, and 2) determined the influence of the passage of time on exposure to drug therapy.


Methods


Using the Quebec provincial administrative databases, we conducted a population -based inception cohort study that included all individuals aged ≥ 65 with a first HF diagnosis between 2000 and 2009 and an ischemic heart disease diagnosis in the year before HF diagnosis. We assessed exposure to HF drug therapy and to drug therapy at target doses at 6, 12, 36 and 60 month intervals after HF diagnosis. Adjusted prevalence ratios (aPR) between age at diagnosis and exposure to drug therapy and the influence of time (6 -month periods) were assessed using multivariate modified Poisson regressions.


Results


Among the 86,428 seni ors, those who were older were less likely to be exposed to both HF drug therapy and drug therapy at target doses at each time point, than were the younger ones (aged 65 -69). The aPRs for exposure to drug therapy for the 90+ age group were 0.64, 0.64, 0.56 and 0.53 at the 6, 12, 36 and 60 month intervals, respectively. After HF diagnosis, exposure increased by a maximum of 8% per 6- month period.


Conclusion


Increasing age is associated with a decrease in exposure to drug therapy, with only slight improvement in exposure after HF diagnosis.

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