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Who receives lipid-lowering drugs: the effects of comorbidities and patient characteristics on treatment initiation.

Abstract：

AIMS:Little is known about the effects of comorbidities and patient characteristics on treatment initiation of lipid-lowering drugs (LLDs), which can be helpful in the evaluation of the risks and benefits of LLDs. METHODS:Baseline characteristics among subjects who received their first ever-recorded LLD prescription in general practice between 1 January 1990 and 31 December 1997, and hyperlipidaemic patients without LLD therapy during the same period were obtained from the UK General Practice Research Database. Differences between patients who received and patients who did not receive LLDs, as well as patients who received different classes of LLDs were compared by fitting multivariate logistic regression models that adjusted for age, sex, body mass index, smoking status, and year of treatment initiation or hyperlipidaemia diagnosis. RESULTS:We found that there were many differences in the baseline characteristics, such as number of general practitioner visits, diagnosis and severity of cardiovascular diseases, and concurrent medications, between the 25 331 patients who received and the 16 287 patients who did not receive LLDs. We also noted that patients with statin therapy had more prior hospitalization, more recent myocardial infarction/stroke, and more concurrent cardiovascular medications, than those patients who received other LLDs. CONCLUSIONS:Patients who received LLDs in primary care, especially patients with statin therapy, were more likely to be elderly and to have more concomitant severe cardiovascular comorbidities than those hyperlipidaemic patients who did not receive LLDs. Examining the medical records of individuals eligible for LLD therapy is an important first step in selectively targeting who will experience the greatest benefit to risk ratio for the treatment of hyperlipidaemia, and is an important step in avoiding confounding by indication when designing epidemiological studies comparing the risks and benefits of treatments for hyperlipidaemia.

journal_name

Br J Clin Pharmacol

journal_title

British journal of clinical pharmacology

authors

Yang CC,Jick SS,Testa MA

doi

10.1046/j.1365-2125.2003.01724.x

keywords:

subject

Has Abstract

pub_date

2003-03-01 00:00:00

pages

288-98

issue

eissn

0306-5251

issn

1365-2125

pii

1724

journal_volume

pub_type

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Who receives lipid-lowering drugs: the effects of comorbidities and patient characteristics on treatment initiation.