Schipper, W.V. (2024) Stoppen en herstarten van cardiovasculaire medicatie bij 70-plussers in de huisartsenpraktijk: een ‘nested’ case-controleonderzoek naar aanleidingen en patiëntkarakteristieken. thesis, Medicine.
Full text available on request.Abstract
Introduction For general practitioners (GP’s), use of cardiovascular medication in (vulnerable) aged people is often a point of debate. Upon ageing, the balance between potential benefits and risks of medication becomes less favorable. The aim of this study is to gain insight into (common) reasons for stopping and restarting cardiovascular medication, and to identify patient characteristics possibly associated with discontinuation. Method This study is a nested case-control study among community-dwelling older people aged 70 to 100 years. Through analysis of medical record texts from GP’s registration data, reasons for stopping and restarting antihypertensives, lipid-lowering agents, and antiplatelet agents in patients with a temporary interruption were examined (cases). The patient characteristics gender, age, cardiovascular history, and vulnerability score were statistically compared with those of individuals without medication interruptions (controls). The association between patient characteristics and (temporary) discontinuation was further analyzed using Cox regression analysis. Results Side effects were the most common reason for temporary discontinuation of lipid-lowering (74,7%), antihypertensive (53,8%), and antiplatelet agents (20,0%). Medication is mostly restarted because of not achieving target values. Higher age and positive cardiovascular history are associated with a lower likelihood of (temporary) discontinuation of lipid-lowering agents. The same association is observed for higher age with antihypertensives, and positive cardiovascular history with antiplatelet agents. Conclusion The recommendations in the guideline for Cardiovascular risk management in (vulnerable) elderly people align with my research findings concerning discontinuation due to side effects. However, my findings do not support discontinuation because of vulnerability or higher age. There appears to be room for deprescription.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Haas, Dr. E.C. de |
| Faculty: | Medical Sciences |
| Date Deposited: | 15 Jan 2025 12:27 |
| Last Modified: | 15 Jan 2025 12:30 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3787 |
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