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Increasing incident statin prescribing for older people and individuals without previous cardiovascular conditions:

Increasing incident statin prescribing for older people and individuals without previous cardiovascular conditions: A nation wide registry study. Helle Wallach Kildemoes, MPH, PhD Morten Andersen, MD, PhD Research Unit of General Practice, Institute of Public Health,

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Increasing incident statin prescribing for older people and individuals without previous cardiovascular conditions:

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  1. Increasing incident statin prescribing for older people and individuals without previous cardiovascular conditions: A nation wide registry study Helle Wallach Kildemoes, MPH, PhD Morten Andersen, MD, PhD Research Unit of General Practice, Institute of Public Health, University of Southern Denmark Odense, Denmark

  2. Background • Statin utilization has increased substantially over the last decade Growing evidence of the beneficial effects of statins in a range of new conditions Lower out-of-pocket costs • A prescribing shift in General Practice: From treatment of post MI patients to general prevention of cardiovascular disease?

  3. Aim • To estimate to what extent incident statin prescribing on new indications accounts for the growth in statin utilisation during the last decade • Analysing prevalence and incidence of treatment according to indication, age and gender

  4. A closed Danish cohort • All Danish inhabitants by January 1 1996 • Statin utilisation among adults were followed in the registries during 1996-2005

  5. Three Registries from Statistics DenmarkLinked by a person code Drug utilization and hospitalization At the individual level Demographic Data Year of birth, gender, date death/emigration Nationwide Prescription Registry (1995-2005) Dispensed out-patient prescriptions antidiabetics and cardiovascular drugs – including statins Dispensing date, ATC code National Patient Registry(1978-2005) Hospital discharge diagnoses and proceduresCardiovascular Diseases (CDV), Diabetes Date, ICD10 /ICD8 codes

  6. Method:Disease markers for Statin indication No information about indication for prescribing Disease markers as a proxy for statin indication CV conditions: Guideline recommendation for statin Assuming CV condition with best evidence: Indication for initiating statin therapy Combined information from Patient and Prescription Registry To assign current CVD status for all cohort members

  7. Methods: Indication hierarchy

  8. Prevalence of Statin Usersby Age

  9. Prevalence of Statin Users by Indication

  10. Incidence of Statin Users by Indication

  11. Incident Statin Prescribingby Indication

  12. Incident Statin Prescribingby Age

  13. Conclusion • Growing statin utilization reflects the broader range of condition for initiating statin treatment • The largest growth in incident statin prescribing was found among the oldest (75+) • Half of the growth in incident prescribing between 2000-2005 is explained by treatment among individuals without prior markers of CVD The middle-aged at CVD risk carry most weight • The changing prescribing behaviours among GP’s- related to the use of the risk score scheme?

  14. Thank you for your attention

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