scholarly journals Statin use and discontinuation in Danes age 70 and older: a nationwide drug utilisation study

2020 ◽  
Author(s):  
Wade Thompson ◽  
Dorte Ejg Jarbøl ◽  
Jesper Bo Nielsen ◽  
Peter Haastrup ◽  
Anton Pottegård
Keyword(s):  
Primary Prevention ◽  
Older Persons ◽  
Drug Utilisation ◽  
Clinical Effects ◽  
Discontinuation Rate ◽  
Limited Evidence ◽  
Factors Associated ◽  
Drug Utilisation Study ◽  
Statin Use

Abstract Background and objective There is limited evidence on the clinical effects of statins in older persons. We aimed to explore statin use and discontinuation patterns in Danes age 70 and older. Design Register-based drug utilisation study. Setting Danish nationwide health registries. Subjects All Danish persons aged ≥70 years between 2011 and 2016. Measurements (1) Monthly prevalence and (2) quarterly incidence of statin use, (3) characteristics of new users, (4) total amount of statin redeemed, (5) statin discontinuation rate between 2014 and 2016 in long-term statin users and (6) factors associated with discontinuation. Results We identified 395,279 unique older statin users between 2011 and 2016. The prevalence increased from 30% in 2011 to 33% in 2016 (23% for primary prevention and 56% for secondary prevention in 2016). The quarterly incidence fell from 11 per 1,000 persons in 2011 to 7 per 1,000 persons in 2016. The prevalence was generally stable in those 70 to 79 years. In those aged ≥80 years, the prevalence increased despite decreasing incidence. The proportion of persons initiating for primary prevention decreased from 58% in 2011 to 52% in 2016. Approximately 19% of long-term statin users discontinued therapy between 2014 and 2016. Increasing age was the strongest predictor of statin discontinuation. Conclusions Approximately one in three Danes age ≥ 70 years were taking statins in 2016. The characteristics of incident users shifted between 2011 and 2016, with less people age 80 and older starting on statins and fewer people starting for primary prevention.

Factors Associated With How Long People Would Like to Live

2019 ◽  
Vol 40 (4) ◽  
pp. 345-352
Author(s):  
Halimah Awang ◽  
Nik Ainoon Nik Osman ◽  
Norma Mansor ◽  
Nur Fakhrina Ab Rashid ◽  
Tan Lih Yoong
Keyword(s):  
Assisted Living ◽  
Older Persons ◽  
Long Term Care ◽  
Healthy Lifestyle ◽  
Assisted Living Facility ◽  
Term Care ◽  
Employment Opportunities ◽  
Factors Associated

This article examined the factors of how long people would like to live involving 462 respondents aged 40 years and older in Malaysia. Data collected through an online self-administered survey indicated that 75% of the respondents would like to live at least 80 years and on average most people would like to live 81 years. Rural respondents, those who agreed that they have a loving family, those who agreed that they want to continue working for as long as they can, respondents who believed that they will not need long-term care at 65 years and older, and those who may consider living in an assisted living facility were more likely to want to live at least 80 years compared with respondents who did not agree. Efforts should be targeted at promoting healthy lifestyle and providing more employment opportunities for older persons.

scholarly journals Longer duration on a Chronic Disease Management plan is associated with long-term adherence to antihypertensive and antithrombotic medications following stroke

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
David Ung ◽  
Monique F Kilkenny ◽  
Muideen T Olaiya ◽  
Joosup Kim ◽  
Thanh Phan ◽  
...  
Keyword(s):  
Disease Management ◽  
Secondary Prevention ◽  
Chronic Disease Management ◽  
Management Plan ◽  
Lipid Lowering ◽  
Limited Evidence ◽  
Factors Associated ◽  
Ischaemic Attack ◽  
Pharmaceutical Benefits Scheme

Introduction and PurposeChronic Disease Management (CDM) plans are used by general practitioners to manage chronic diseases such as stroke. However, there is limited evidence that being on these plans improve adherence to secondary prevention medications after stroke. We aimed to assess the association of the duration on a CDM plan in improving adherence to secondary prevention medications following stroke. MethodsAustralian survivors of stroke or transient ischaemic attack were participants from the STAND FIRM trial. Patients were individually linked with claims for CDM plans from Medicare and dispensings of secondary prevention medications from the Pharmaceutical Benefits Scheme. We estimated (1) duration on a CDM plan based on the timing and Medicare items claimed and (2) the proportion of days that patients would have been covered by these medications (PDC), while accounting for deaths and instances of over-supply. Dosage for each quantity of medication was determined by the regularity in which patients returned for a refill. Logistic regression was used to evaluate factors associated with ≥80% adherence, up to 3 years after stroke, for each of antihypertensive, antithrombotic and lipid-modifying drugs. ResultsThe median PDC for 563 patients (median age 70yrs; 36% female) ranged from 92% to 95% among the three classes of medications. Approximately 27% did not take up a CDM plan, 33% were on plans for <1.5 years and 40% for 1.5-3 years. Duration on a CDM plan (quintiles) was associated with adherence for antihypertensive (Odds Ratio (OR) 1.18, 95% confidence interval (95%CI) 1.00-1.40, p=0.029) and antithrombotic medications (OR 1.22, 95%CI 1.03-1.46, p=0.024), but not for lipid-lowering medications. ConclusionPeople on a CDM plan for longer had better adherence to antihypertensive and antithrombotic medications in the long-term after stroke. Use and ongoing reviews of CDM plans should be encouraged to improve adherence to secondary prevention medications after stroke.

scholarly journals Long-term dynamics of population morbidity with malignant neoplasms of trachea, bronchi, lung in Western Siberia (retrospective descriptive study for years 2006–2017)

2020 ◽  
pp. 29-31
Author(s):  
V. L. Stasenko ◽  
N. G. Shirlina ◽  
V. A. Shirinsky ◽  
N. V. Shirinskaya ◽  
V. G. Demchenko ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Primary Prevention ◽  
Cancer Incidence ◽  
Western Siberia ◽  
Descriptive Study ◽  
National Average ◽  
Malignant Neoplasms ◽  
Factors Associated ◽  
Dynamics Of Population

The purpose of this study is to assess the dynamics of the incidence of trachea, bronchi, lung cancer in the Omsk Region over a 12year period.Materials and methods. The analysis of long-term dynamics of morbidity of the population of the Omsk Region with cancer of the trachea, bronchi, lung (RTBL) for the years 2006–2017.Results. In the structure of cancer incidence in the Omsk Region, the proportion of RTBL was 12.4 % that was higher than the national average (11.0 %; p < 0.001). In dynamics for the period of 2006–2017 morbidity of inhabitants of the region of ZNO of trachea, bronchus, lung did not change (T = 0.15 %; p < 0.001). Incidence of RTBL in the Omsk Region tended to increase in general (from 46.9 to 51.3 0/000; p < 0.001) and decrease in standardized (from 25.9 to 24.1 0/000; p < 0.001) indicators.Conclusion. 1. In the Omsk region over a 12-year period, the incidence of RTBL remained stable (long-term average 51.0 0/0000; 95 % CI: 48.4–54.1). 2. The absence of positive changes in the dynamics of morbidity of the population of RTBL in the Omsk Region requires a study of the prevalence of known factors associated with the risk of developing this pathology and the improvement of approaches to primary prevention, taking into account regional characteristics.

Strengthening of occupational health promotion by the German Prevention Health Care Act

2019 ◽  
pp. 188-190
Author(s):  
Diana Hart
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Promotion ◽  
Primary Prevention ◽  
Occupational Health ◽  
Life Expectancy ◽  
Prevention And Control ◽  
Occupational Health Promotion ◽  
And Control

All countries are faced with the problem of the prevention and control of non-communicable diseases (NCD): implement prevention strategies eff ectively, keep up the momentum with long term benefi ts at the individual and the population level, at the same time tackling hea lth inequalities. Th e aff ordability of therapy and care including innovative therapies is going to be one of the key public health priorities in the years to come. Germany has taken in the prevention and control of NCDs. Germany’s health system has a long history of guaranteeing access to high-quality treatment through universal health care coverage. Th r ough their membership people are entitled to prevention and care services maintaining and restoring their health as well as long term follow-up. Like in many other countries general life expectancy has been increasing steadily in Germany. Currently, the average life expectancy is 83 and 79 years in women and men, respectively. Th e other side of the coin is that population aging is strongly associated with a growing burden of disease from NCDs. Already over 70 percent of all deaths in Germany are caused by four disease entities: cardiovascular disease, cancer, chronic respiratory disease and diabetes. Th ese diseases all share four common risk factors: smoking, alcohol abuse, lack of physical activity and overweight. At the same time, more and more people become long term survivors of disease due to improved therapy and care. Th e German Government and public health decision makers are aware of the need for action and have responded by initiating and implementing a wide spectrum of activities. One instrument by strengthening primary prevention is the Prevention Health Care Act. Its overarching aim is to prevent NCDs before they can manifest themselves by strengthening primary prevention and health promotion in diff erent sett ings. One of the main emphasis of the Prevention Health Care Act is the occupational health promotion at the workplace.

Physical activity and cognitive function in older persons

2016 ◽  
Vol 64 (2) ◽  
Keyword(s):  
Physical Activity ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Executive Functions ◽  
Cognitive Aging ◽  
Clinical Studies ◽  
Older Persons ◽  
Positive Effects ◽  
Critical Challenge

Strategies to improve cognitive aging are highly needed. Among those, promotion of exercise and physical activity appears as one of the most attractive and beneficial intervention. Indeed, results from basic and clinical studies suggest that exercise and physical activity have positive effects on cognition in older persons without cognitive impairment, as well as in those with dementia. Despite inconsistent results, aerobic exercise appears to have the strongest potential to enhance cognition. However, even limited periods of walking (45 minutes, three times a week, over a 6-month period) have also been shown to enhance cognition, particularly executive functions. Changing long-term lifestyle habits in these older persons remains a critical challenge and attractive programs susceptible to gain adherence are needed to succeed in achieving improved cognitive aging.

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