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dc.contributor.authorTjia, Jennifer
dc.contributor.authorBriesacher, Becky A.
dc.contributor.authorXie, Dawei
dc.contributor.authorFu, Jason
dc.contributor.authorGoldberg, Robert J.
dc.date2022-08-11T08:10:39.000
dc.date.accessioned2022-08-23T17:15:41Z
dc.date.available2022-08-23T17:15:41Z
dc.date.issued2010-01-29
dc.date.submitted2010-05-27
dc.identifier.citationDrugs Aging. 2010;27(2):149-58. doi: 10.2165/11532150-000000000-00000. <a href="http://dx.doi.org/10.2165/11532150-000000000-00000">Link to article on publisher's site</a>
dc.identifier.issn1170-229X (Linking)
dc.identifier.doi10.2165/11532150-000000000-00000
dc.identifier.pmid20104940
dc.identifier.urihttp://hdl.handle.net/20.500.14038/47221
dc.description.abstractBACKGROUND: Despite evidence of effective combination drug therapy for secondary prevention of coronary heart disease (CHD), older adults with this condition remain undertreated. OBJECTIVE: To describe time trends (1992-2003) in the adoption of combination cardiac drug therapies (beta-blockers [beta-adrenoceptor antagonists], ACE inhibitors or angiotensin II type 1 receptor antagonists [angiotensin receptor blockers; ARBs], and lipid-lowering agents) among older adults in the US with CHD and to identify factors associated with not using combination therapy. METHODS: The study took the form of a cross-sectional time-series. The study population consisted of a nationally representative sample of adults aged >or=65 years with CHD (unweighted n = 6331; weighted n = 20.1 million) included in the 1992-2003 Medicare Current Beneficiary Survey. The outcome measure was low-intensity cardiac pharmacotherapy (no drug or single drug therapy with beta-blockers, ACE inhibitors/ARBs or lipid-lowering agents) compared with combination therapy (>or=2 cardiac drugs) for secondary CHD prevention. RESULTS: The use of combination drug therapy in older adults with CHD increased 9-fold during the study period (from 6% in 1992 to 54% in 2003). Adjusted analyses demonstrate that suboptimal drug therapy was independently associated with advanced age (relative risk [RR] 1.18; 95% CI 1.14, 1.23) for patients aged >or=85 years versus patients aged 65-74 years, and with being non-Hispanic Black (RR 1.05; 95% CI 1.01, 1.10) or Hispanic (RR 1.13; 95% CI 1.06, 1.21) versus being non-Hispanic White. CONCLUSIONS: Combination drug therapy use for secondary CHD prevention increased in older US adults over the last decade, but improvements were not uniform. The oldest-old, non-Hispanic Blacks and Hispanics experienced slower adoption of optimal medical therapy to improve their long-term prognosis for CHD.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=20104940&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.2165/11532150-000000000-00000
dc.subjectAdrenergic beta-Antagonists
dc.subjectAdult
dc.subjectAged
dc.subjectAngiotensin-Converting Enzyme Inhibitors
dc.subjectAntihypertensive Agents
dc.subjectCardiovascular Agents
dc.subjectCardiovascular Diseases
dc.subjectCoronary Disease
dc.subjectDrug Prescriptions
dc.subjectDrug Therapy, Combination
dc.subjectEthnic Groups
dc.subjectHumans
dc.subject*Medicare
dc.subject*Physician's Practice Patterns
dc.subjectSex Factors
dc.subjectUnited States
dc.subjectBioinformatics
dc.subjectBiostatistics
dc.subjectEpidemiology
dc.subjectHealth Services Research
dc.titleDisparities in combination drug therapy use in older adults with coronary heart disease: a cross-sectional time-series in a nationally representative US sample
dc.typeJournal Article
dc.source.journaltitleDrugs and aging
dc.source.volume27
dc.source.issue2
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/365
dc.identifier.contextkey1333119
html.description.abstract<p>BACKGROUND: Despite evidence of effective combination drug therapy for secondary prevention of coronary heart disease (CHD), older adults with this condition remain undertreated.</p> <p>OBJECTIVE: To describe time trends (1992-2003) in the adoption of combination cardiac drug therapies (beta-blockers [beta-adrenoceptor antagonists], ACE inhibitors or angiotensin II type 1 receptor antagonists [angiotensin receptor blockers; ARBs], and lipid-lowering agents) among older adults in the US with CHD and to identify factors associated with not using combination therapy.</p> <p>METHODS: The study took the form of a cross-sectional time-series. The study population consisted of a nationally representative sample of adults aged >or=65 years with CHD (unweighted n = 6331; weighted n = 20.1 million) included in the 1992-2003 Medicare Current Beneficiary Survey. The outcome measure was low-intensity cardiac pharmacotherapy (no drug or single drug therapy with beta-blockers, ACE inhibitors/ARBs or lipid-lowering agents) compared with combination therapy (>or=2 cardiac drugs) for secondary CHD prevention.</p> <p>RESULTS: The use of combination drug therapy in older adults with CHD increased 9-fold during the study period (from 6% in 1992 to 54% in 2003). Adjusted analyses demonstrate that suboptimal drug therapy was independently associated with advanced age (relative risk [RR] 1.18; 95% CI 1.14, 1.23) for patients aged >or=85 years versus patients aged 65-74 years, and with being non-Hispanic Black (RR 1.05; 95% CI 1.01, 1.10) or Hispanic (RR 1.13; 95% CI 1.06, 1.21) versus being non-Hispanic White.</p> <p>CONCLUSIONS: Combination drug therapy use for secondary CHD prevention increased in older US adults over the last decade, but improvements were not uniform. The oldest-old, non-Hispanic Blacks and Hispanics experienced slower adoption of optimal medical therapy to improve their long-term prognosis for CHD.</p>
dc.identifier.submissionpathqhs_pp/365
dc.contributor.departmentDepartment of Medicine, Division of Geriatric Medicine
dc.contributor.departmentMeyers Primary Care Institute
dc.contributor.departmentDepartment of Medicine, Division of Cardiovascular Medicine
dc.source.pages149-58


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