Long-term use of antiplatelet drugs by patients with transient ischaemic attack
Purpose To determine the degree of long-term non-persistence to antiplatelet drugs in patients with transient ischaemic attack (TIA) and identify determinants of this drug-use pattern. Methods We used community-based prescription registry data to determine antiplatelet drug use in TIA patients prese...
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| Veröffentlicht in: | European journal of clinical pharmacology 2014-02, Vol.70 (2), p.241-248 |
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| container_title | European journal of clinical pharmacology |
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| creator | Østergaard, Kamilla Madsen, Charlotte Liu, Marie-Louise Bak, Søren Hallas, Jesper Gaist, David |
| description | Purpose
To determine the degree of long-term non-persistence to antiplatelet drugs in patients with transient ischaemic attack (TIA) and identify determinants of this drug-use pattern.
Methods
We used community-based prescription registry data to determine antiplatelet drug use in TIA patients presenting to a Danish neurology department in the period 2006–2010. Non-persistence was defined as failure to present a prescription for antiplatelet drugs within 180 days after the dosage of a previous prescription had run out. We used Cox regression to calculate the hazard ratio (HR) for non-persistence and the corresponding 95 % confidence interval (CI) by potential determinants, including a stroke risk score (ABCD2 score). Adherence during follow-up [80 % medication possession ratio (MPR80)] was calculated for antiplatelets, statins and antihypertensive drugs.
Results
The cohort comprised 594 (84 % evaluated as in-patients) TIA patients. During follow-up (median 1.7 years, interquartile range 0.9–3.0 years), 140 (23.6 %) patients became non-persistent. Non-persistence was associated with younger age ( |
| doi_str_mv | 10.1007/s00228-013-1609-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1490711011</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1490711011</sourcerecordid><originalsourceid>FETCH-LOGICAL-c402t-f9753b507a5069233e1528ada8f3406a622d3df6a3b2bd8e6645374ea910db913</originalsourceid><addsrcrecordid>eNp1kU2LFDEQhoMo7uzqD_AiAVnwEq1K0knnKIvrCgN70XOo7k7P9tofY5JG9t9vhhk_EPYUijxV9fIUY28QPiCA_ZgApKwFoBJowAn5jG1QKykQND5nGwCFwjgLZ-w8pXsArByol-xMaqmt0bhht9tl3okc4sTXFPjSc5rzsB8phzFk3sV1l3jzwPeUhzDnxH8N-Y7nSHM61HxI7R2FaWg55Uztj1fsRU9jCq9P7wX7fv3529WN2N5--Xr1aStaDTKL3tlKNRVYqsA4qVTAStbUUd0rDYaMlJ3qekOqkU1XB2N0pawO5BC6xqG6YO-Pc_dx-bmGlP1UooRxpDksa_KoHVhEwAP67j_0flnjXNIVylqHEnRdKDxSbVxSiqH3-zhMFB88gj_Y9kfbvtj2B9telp63p8lrM4XuT8dvvQW4PAGUWhr7oq0d0l-urlCW-xROHrlUvuZdiP9EfHL7IwV6lWY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1477912048</pqid></control><display><type>article</type><title>Long-term use of antiplatelet drugs by patients with transient ischaemic attack</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Østergaard, Kamilla ; Madsen, Charlotte ; Liu, Marie-Louise ; Bak, Søren ; Hallas, Jesper ; Gaist, David</creator><creatorcontrib>Østergaard, Kamilla ; Madsen, Charlotte ; Liu, Marie-Louise ; Bak, Søren ; Hallas, Jesper ; Gaist, David</creatorcontrib><description>Purpose
To determine the degree of long-term non-persistence to antiplatelet drugs in patients with transient ischaemic attack (TIA) and identify determinants of this drug-use pattern.
Methods
We used community-based prescription registry data to determine antiplatelet drug use in TIA patients presenting to a Danish neurology department in the period 2006–2010. Non-persistence was defined as failure to present a prescription for antiplatelet drugs within 180 days after the dosage of a previous prescription had run out. We used Cox regression to calculate the hazard ratio (HR) for non-persistence and the corresponding 95 % confidence interval (CI) by potential determinants, including a stroke risk score (ABCD2 score). Adherence during follow-up [80 % medication possession ratio (MPR80)] was calculated for antiplatelets, statins and antihypertensive drugs.
Results
The cohort comprised 594 (84 % evaluated as in-patients) TIA patients. During follow-up (median 1.7 years, interquartile range 0.9–3.0 years), 140 (23.6 %) patients became non-persistent. Non-persistence was associated with younger age (<55 years: HR 1.9, 95 % CI 1.3–2.8) and delay between TIA onset and neurological evaluation (7+ days: HR 2.0, 95 % CI 1.0–4.1). Among admitted patients, a higher ABCD2 score (4+: HR 1.3, 95 % CI 0.8–2.1) was also indicative of non-persistence. Non-persistent users were less adherent to other preventive medication (MPR80: statins 31.8 vs. 75.3 %,
p
value < 0.001; antihypertensives 64.3 vs. 79.5 %,
p
value: 0.02) than persistent users.
Conclusion
Long-term antiplatelet non-persistence was most pronounced in patients of younger age, those with delayed evaluation of symptoms and those at greater risk of stroke. It was also associated with a lower adherence to preventive medication in general.</description><identifier>ISSN: 0031-6970</identifier><identifier>EISSN: 1432-1041</identifier><identifier>DOI: 10.1007/s00228-013-1609-2</identifier><identifier>PMID: 24247641</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Biomedical and Life Sciences ; Biomedicine ; Cohort Studies ; Databases, Factual ; Denmark - epidemiology ; Drug therapy ; Drug use ; Female ; Humans ; Ischemia ; Ischemic Attack, Transient - drug therapy ; Ischemic Attack, Transient - epidemiology ; Male ; Medical sciences ; Medication Adherence - statistics & numerical data ; Middle Aged ; Pharmacoepidemiology and Prescription ; Pharmacology ; Pharmacology. Drug treatments ; Pharmacology/Toxicology ; Platelet Aggregation Inhibitors - therapeutic use ; Prescription drugs</subject><ispartof>European journal of clinical pharmacology, 2014-02, Vol.70 (2), p.241-248</ispartof><rights>Springer-Verlag Berlin Heidelberg 2013</rights><rights>2015 INIST-CNRS</rights><rights>Springer-Verlag Berlin Heidelberg 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c402t-f9753b507a5069233e1528ada8f3406a622d3df6a3b2bd8e6645374ea910db913</citedby><cites>FETCH-LOGICAL-c402t-f9753b507a5069233e1528ada8f3406a622d3df6a3b2bd8e6645374ea910db913</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00228-013-1609-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00228-013-1609-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28512697$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24247641$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Østergaard, Kamilla</creatorcontrib><creatorcontrib>Madsen, Charlotte</creatorcontrib><creatorcontrib>Liu, Marie-Louise</creatorcontrib><creatorcontrib>Bak, Søren</creatorcontrib><creatorcontrib>Hallas, Jesper</creatorcontrib><creatorcontrib>Gaist, David</creatorcontrib><title>Long-term use of antiplatelet drugs by patients with transient ischaemic attack</title><title>European journal of clinical pharmacology</title><addtitle>Eur J Clin Pharmacol</addtitle><addtitle>Eur J Clin Pharmacol</addtitle><description>Purpose
To determine the degree of long-term non-persistence to antiplatelet drugs in patients with transient ischaemic attack (TIA) and identify determinants of this drug-use pattern.
Methods
We used community-based prescription registry data to determine antiplatelet drug use in TIA patients presenting to a Danish neurology department in the period 2006–2010. Non-persistence was defined as failure to present a prescription for antiplatelet drugs within 180 days after the dosage of a previous prescription had run out. We used Cox regression to calculate the hazard ratio (HR) for non-persistence and the corresponding 95 % confidence interval (CI) by potential determinants, including a stroke risk score (ABCD2 score). Adherence during follow-up [80 % medication possession ratio (MPR80)] was calculated for antiplatelets, statins and antihypertensive drugs.
Results
The cohort comprised 594 (84 % evaluated as in-patients) TIA patients. During follow-up (median 1.7 years, interquartile range 0.9–3.0 years), 140 (23.6 %) patients became non-persistent. Non-persistence was associated with younger age (<55 years: HR 1.9, 95 % CI 1.3–2.8) and delay between TIA onset and neurological evaluation (7+ days: HR 2.0, 95 % CI 1.0–4.1). Among admitted patients, a higher ABCD2 score (4+: HR 1.3, 95 % CI 0.8–2.1) was also indicative of non-persistence. Non-persistent users were less adherent to other preventive medication (MPR80: statins 31.8 vs. 75.3 %,
p
value < 0.001; antihypertensives 64.3 vs. 79.5 %,
p
value: 0.02) than persistent users.
Conclusion
Long-term antiplatelet non-persistence was most pronounced in patients of younger age, those with delayed evaluation of symptoms and those at greater risk of stroke. It was also associated with a lower adherence to preventive medication in general.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Cohort Studies</subject><subject>Databases, Factual</subject><subject>Denmark - epidemiology</subject><subject>Drug therapy</subject><subject>Drug use</subject><subject>Female</subject><subject>Humans</subject><subject>Ischemia</subject><subject>Ischemic Attack, Transient - drug therapy</subject><subject>Ischemic Attack, Transient - epidemiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medication Adherence - statistics & numerical data</subject><subject>Middle Aged</subject><subject>Pharmacoepidemiology and Prescription</subject><subject>Pharmacology</subject><subject>Pharmacology. Drug treatments</subject><subject>Pharmacology/Toxicology</subject><subject>Platelet Aggregation Inhibitors - therapeutic use</subject><subject>Prescription drugs</subject><issn>0031-6970</issn><issn>1432-1041</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kU2LFDEQhoMo7uzqD_AiAVnwEq1K0knnKIvrCgN70XOo7k7P9tofY5JG9t9vhhk_EPYUijxV9fIUY28QPiCA_ZgApKwFoBJowAn5jG1QKykQND5nGwCFwjgLZ-w8pXsArByol-xMaqmt0bhht9tl3okc4sTXFPjSc5rzsB8phzFk3sV1l3jzwPeUhzDnxH8N-Y7nSHM61HxI7R2FaWg55Uztj1fsRU9jCq9P7wX7fv3529WN2N5--Xr1aStaDTKL3tlKNRVYqsA4qVTAStbUUd0rDYaMlJ3qekOqkU1XB2N0pawO5BC6xqG6YO-Pc_dx-bmGlP1UooRxpDksa_KoHVhEwAP67j_0flnjXNIVylqHEnRdKDxSbVxSiqH3-zhMFB88gj_Y9kfbvtj2B9telp63p8lrM4XuT8dvvQW4PAGUWhr7oq0d0l-urlCW-xROHrlUvuZdiP9EfHL7IwV6lWY</recordid><startdate>20140201</startdate><enddate>20140201</enddate><creator>Østergaard, Kamilla</creator><creator>Madsen, Charlotte</creator><creator>Liu, Marie-Louise</creator><creator>Bak, Søren</creator><creator>Hallas, Jesper</creator><creator>Gaist, David</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20140201</creationdate><title>Long-term use of antiplatelet drugs by patients with transient ischaemic attack</title><author>Østergaard, Kamilla ; Madsen, Charlotte ; Liu, Marie-Louise ; Bak, Søren ; Hallas, Jesper ; Gaist, David</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c402t-f9753b507a5069233e1528ada8f3406a622d3df6a3b2bd8e6645374ea910db913</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Cohort Studies</topic><topic>Databases, Factual</topic><topic>Denmark - epidemiology</topic><topic>Drug therapy</topic><topic>Drug use</topic><topic>Female</topic><topic>Humans</topic><topic>Ischemia</topic><topic>Ischemic Attack, Transient - drug therapy</topic><topic>Ischemic Attack, Transient - epidemiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medication Adherence - statistics & numerical data</topic><topic>Middle Aged</topic><topic>Pharmacoepidemiology and Prescription</topic><topic>Pharmacology</topic><topic>Pharmacology. Drug treatments</topic><topic>Pharmacology/Toxicology</topic><topic>Platelet Aggregation Inhibitors - therapeutic use</topic><topic>Prescription drugs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Østergaard, Kamilla</creatorcontrib><creatorcontrib>Madsen, Charlotte</creatorcontrib><creatorcontrib>Liu, Marie-Louise</creatorcontrib><creatorcontrib>Bak, Søren</creatorcontrib><creatorcontrib>Hallas, Jesper</creatorcontrib><creatorcontrib>Gaist, David</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of clinical pharmacology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Østergaard, Kamilla</au><au>Madsen, Charlotte</au><au>Liu, Marie-Louise</au><au>Bak, Søren</au><au>Hallas, Jesper</au><au>Gaist, David</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term use of antiplatelet drugs by patients with transient ischaemic attack</atitle><jtitle>European journal of clinical pharmacology</jtitle><stitle>Eur J Clin Pharmacol</stitle><addtitle>Eur J Clin Pharmacol</addtitle><date>2014-02-01</date><risdate>2014</risdate><volume>70</volume><issue>2</issue><spage>241</spage><epage>248</epage><pages>241-248</pages><issn>0031-6970</issn><eissn>1432-1041</eissn><abstract>Purpose
To determine the degree of long-term non-persistence to antiplatelet drugs in patients with transient ischaemic attack (TIA) and identify determinants of this drug-use pattern.
Methods
We used community-based prescription registry data to determine antiplatelet drug use in TIA patients presenting to a Danish neurology department in the period 2006–2010. Non-persistence was defined as failure to present a prescription for antiplatelet drugs within 180 days after the dosage of a previous prescription had run out. We used Cox regression to calculate the hazard ratio (HR) for non-persistence and the corresponding 95 % confidence interval (CI) by potential determinants, including a stroke risk score (ABCD2 score). Adherence during follow-up [80 % medication possession ratio (MPR80)] was calculated for antiplatelets, statins and antihypertensive drugs.
Results
The cohort comprised 594 (84 % evaluated as in-patients) TIA patients. During follow-up (median 1.7 years, interquartile range 0.9–3.0 years), 140 (23.6 %) patients became non-persistent. Non-persistence was associated with younger age (<55 years: HR 1.9, 95 % CI 1.3–2.8) and delay between TIA onset and neurological evaluation (7+ days: HR 2.0, 95 % CI 1.0–4.1). Among admitted patients, a higher ABCD2 score (4+: HR 1.3, 95 % CI 0.8–2.1) was also indicative of non-persistence. Non-persistent users were less adherent to other preventive medication (MPR80: statins 31.8 vs. 75.3 %,
p
value < 0.001; antihypertensives 64.3 vs. 79.5 %,
p
value: 0.02) than persistent users.
Conclusion
Long-term antiplatelet non-persistence was most pronounced in patients of younger age, those with delayed evaluation of symptoms and those at greater risk of stroke. It was also associated with a lower adherence to preventive medication in general.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>24247641</pmid><doi>10.1007/s00228-013-1609-2</doi><tpages>8</tpages></addata></record> |
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| ispartof | European journal of clinical pharmacology, 2014-02, Vol.70 (2), p.241-248 |
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| subjects | Adult Aged Aged, 80 and over Biological and medical sciences Biomedical and Life Sciences Biomedicine Cohort Studies Databases, Factual Denmark - epidemiology Drug therapy Drug use Female Humans Ischemia Ischemic Attack, Transient - drug therapy Ischemic Attack, Transient - epidemiology Male Medical sciences Medication Adherence - statistics & numerical data Middle Aged Pharmacoepidemiology and Prescription Pharmacology Pharmacology. Drug treatments Pharmacology/Toxicology Platelet Aggregation Inhibitors - therapeutic use Prescription drugs |
| title | Long-term use of antiplatelet drugs by patients with transient ischaemic attack |
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