The prescription of antiplatelet medication in a very elderly population: An observational study in 15 141 ambulatory subjects

Int J Clin Pract. 2017 Dec;71(12). doi: 10.1111/ijcp.13020. Epub 2017 Sep 21.

Abstract

Objective: Despite the frequent use of antiplatelet medication (AM) in the elderly patients, very few studies have investigated its prescription. We describe AM prescription through retrospective study in ambulatory elderly patients.

Method: All subjects aged over 80 years with a medical prescription delivered in March 2015 and affiliated to the Mutualité Sociale Agricole de Bourgogne. Subjects with prescriptions for AM were compared with those without.

Results: A total of 15 141 ambulatory elderly patients (83-89 years, 61.3% of women) were included and 4412 (29.14%) had a prescription for AM. The latter were more frequently men than those without AM (43% vs 36.93%, P < .0001) and more frequently had chronic comorbidities (77.24% vs 64.65%, P < .0001). Compared with ambulatory subjects without AM, those with AM more frequently had coronary heart disease (35.15% vs 14.49%), severe hypertension (30% vs 25.65%), diabetes (27.42% vs 20.64%), peripheral arterial diseases (16.28% vs 5.96%) and disabling stroke (9% vs 5.56% (all P < .0001). In addition, they had more prescriptions of beta-blockers (45.24% vs 36.90%), angiotensin conversion enzyme inhibitor (31.35% vs 25.44%), calcium channel blockers (33.34% vs 27.90%), nitrate derivatives (10.6% vs 6.03%) or hypolipidemic agents (HA; 49.81% vs 29.72%) (all P < .0001) than those without AM.

Conclusion: In this study, which is very interested for its size and the advanced age of the subjects, long-course AM was prescribed in one third of ambulatory elderly patients. Coronary heart disease, severe hypertension and diabetes were more frequent in AM subjects. However, the low percentage of declared strokes was surprising. We provide additional data to doctors following subjects with AM.

Publication types

  • Observational Study

MeSH terms

  • Aged, 80 and over
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Calcium Channel Blockers / therapeutic use
  • Coronary Disease / epidemiology
  • Diabetes Mellitus / epidemiology
  • Drug Prescriptions / statistics & numerical data*
  • Female
  • France / epidemiology
  • Humans
  • Hypertension / epidemiology
  • Hypolipidemic Agents / therapeutic use
  • Male
  • Peripheral Arterial Disease / epidemiology
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Polypharmacy
  • Retrospective Studies
  • Stroke / epidemiology

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Calcium Channel Blockers
  • Hypolipidemic Agents
  • Platelet Aggregation Inhibitors