Age-Related Variation in the Provision of Primary Care Services and Medication Prescriptions for Patients with Cardiovascular Disease

Int J Environ Res Public Health. 2022 Aug 29;19(17):10761. doi: 10.3390/ijerph191710761.

Abstract

As population aging progresses, demands of patients with cardiovascular diseases (CVD) on the primary care services is inevitably increased. However, the utilisation of primary care services across varying age groups is unknown. The study aims to explore age-related variations in provision of chronic disease management plans, mental health care, guideline-indicated cardiovascular medications and influenza vaccination among patients with CVD over differing ages presenting to primary care. Data for patients with CVD were extracted from 50 Australian general practices. Logistic regression, accounting for covariates and clustering effects by practices, was used for statistical analysis. Of the 14,602 patients with CVD (mean age, 72.5 years), patients aged 65-74, 75-84 and ≥85 years were significantly more likely to have a GP management plan prepared (adjusted odds ratio (aOR): 1.6, 1.88 and 1.55, respectively, p < 0.05), have a formal team care arrangement (aOR: 1.49, 1.8, 1.65, respectively, p < 0.05) and have a review of either (aOR: 1.63, 2.09, 1.93, respectively, p < 0.05) than those < 65 years. Patients aged ≥ 65 years were more likely to be prescribed blood-pressure-lowering medications and to be vaccinated for influenza. However, the adjusted odds of being prescribed lipid-lowering and antiplatelet medications and receiving mental health care were significantly lowest among patients ≥ 85 years. There are age-related variations in provision of primary care services and pharmacological therapy. GPs are targeting care plans to older people who are more likely to have long-term conditions and complex needs.

Keywords: age; cardiovascular disease; primary care; risk factors; secondary prevention.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Australia
  • Cardiovascular Diseases* / epidemiology
  • Drug Prescriptions
  • Humans
  • Influenza, Human*
  • Primary Health Care

Grants and funding

This study is part of a large project (QUEL) which was funded by a National Health and Medical Research Council (NHMRC) Partnership Project Grant (APP1140807). The study received in-kind and cash support from the following partners: Amgen (cash support), Austin Health, Australian Cardiovascular Health and Rehabilitation Association, Australian Commission on Safety and Quality in Health Care, Australian Primary Health Care Nurses Association, Brisbane South PHN, Fairfield General Practice Unit, Heart Support Australia, Improvement Foundation, Inala Primary Care, National Heart Foundation of Australia, Nepean Blue Mountains PHN (cash support), Royal Australian College of General Practitioners, Sanofi (cash support), South Western Sydney PHN, The George Institute for Global Health (cash support) and University of Melbourne. J.R. is supported by a NHMRC Career Development Fellowship (APP1143538). K.H. is supported by the National Heart Foundation of Australia Postdoctoral Fellowship (102138). M.W. is supported by NHMRC grants (1080206 and 1149987). C.M.R. is supported by a NHMRC Principal Research Fellowship (APP1136372). T.L. is funded by a NHMRC Early Career Fellowship (App110230). E.R.A. was supported by a National Heart Foundation Australia postdoctoral fellowship (101884). C.K.C. is funded by a Career Development Fellowship level 2 co-funded by the NHMRC and National Heart Foundation Future Leader Award (APP1105447).