Ananias, Elisabeth F.M. (2012) Stoppen met cholesterol verlagende medicatie bij ouderen met diabetes mellitus type II: een cohort onderzoek naar de aard, omvang en gevolgen. thesis, Medicine.
Full text available on request.Abstract
Introduction: Elderly of 65 years and older with diabetes mellitus type II probably benefit less from preventive cholesterol lowering medication than younger patients because of more complex health problems, reduced quality of life and limited life expectancy. In the elderly, it is questionable whether the medication burden outweighs the benefits of statin therapy and stopping statin therapy could be considered. In addition, co-morbidity, polypharmacy and experiencing adverse side effects may lead to reduced adherence or stopping statins. There is little known about the size and effects of stopping statins in elderly diabetes patients and therefore it is interesting to study this further. Objectives: The aim of this study is to investigate the nature and extent of the problem elderly and stopping preventive medication and to identify whether stoppers have a greater chance of developing cholesterol and lipid related morbidity and mortality than users. Material and method: The research consists of a (1) descriptive and a (2) prospective part. Using the data collection of Groningen Initiative to Analyze Type 2 Diabetes Treatment (GIANTT), it will be assessed how many patients stop statins in the years 2006 and 2007 and whether they differ from users of statins. In the second part, the effect of stopping statins will be studied in terms of mortality, morbidity and LDL-cholesterol values. Stoppers will be compared to users and to non users, correcting for confounding factors. Results: There are 5253 patients included, of which almost 83% (did) use(s) statins. In this population there are 236 stoppers, 2175 users and 1085 non users. The remaining 1757 patients did use statins less than 2 years or have incomplete data and are not included in the analysis. A higher LDL-cholesterol and higher age are predictive factors for stopping statins. Stoppers and users or non users differ with regards to mortality, morbidity, cerebral diseases and LDL-cholesterol. Stopping statins is predictive for developing cerebral diseases and high LDL-cholesterol. Conclusion: Approximately 10% of the patients aged 65 years and older, who did use statins for at least 2 years, stop using this medicine in a period of 2 years. These stoppers are people with a negative risk profile. People who stop have a greater chance of developing cerebral diseases and further deterioration of LDL-cholesterol. For this reason, older diabetes type II patients better not stop cholesterol lowering medication, but better continue using them.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Haaijer-Ruskamp. Prof. dr. F.M. and Denig, Dr. P. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:48 |
| Last Modified: | 25 Jun 2020 10:48 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/947 |
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