METHODS: The study included all statin-treated patients older than 75 years at the five participating institutions (including long-term nursing homes). In a prospective multicenter study, the benefit/risk ratio of statin prescription has been assessed up. Depending on the clinical situation, a proposal to stop or adjust the dosage could be made.
RESULTS: Nine hundred and forty-seven patients were included. Among them, 184 were treated with a statin. Forty-seven patients (26%) are treated in primary prevention and 137 patients (74%) in secondary prevention. Dosages are lower for long stays. Fifteen treatments interruption were accepted out of 44 proposals, mostly for long stays. The reasons given to continue treatment are the need for a new evaluation by a cardiologist or a high cardiovascular risk.
CONCLUSIONS: The variability of results according to the type healthcare institution makes territorial medical and pharmaceutical collaboration relevant. The challenge is to develop a coherent care pathway for optimal care of elderly patients, with congruent objectives.
方法:该研究纳入了5个参与机构(包括长期疗养院)中所有75岁以上接受他汀类药物治疗的患者。在一项前瞻性多中心研究中,对他汀类药物处方的获益/风险比进行了评估.根据临床情况,可以提出停止或调整剂量的建议。
结果:纳入947例患者。其中,184例接受他汀类药物治疗。47名患者(26%)接受一级预防治疗,137名患者(74%)接受二级预防治疗。长期停留的剂量较低。44项建议中有15项治疗中断被接受,主要是长期停留。继续治疗的原因是需要心脏病专家进行新的评估或心血管风险高。
结论:根据医疗机构的类型,结果的可变性使地区医疗和制药合作具有相关性。面临的挑战是开发一个连贯的护理途径,以优化老年患者的护理,有一致的目标。