Change in Prescribing forSecondary Prevention of Stroke and Coronary Heart Disease in Finnish Nursing Homes and Assisted Living Facilities

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Jokanovic , N , Kautiainen , H , Bell , J S , Tan , E C K & Pitkälä , K H 2019 , ' Change in Prescribing forSecondary Prevention of Stroke and Coronary Heart Disease in Finnish Nursing Homes and Assisted Living Facilities ' , Drugs & Aging , vol. 36 , no. 6 , pp. 571-579 . https://doi.org/10.1007/s40266-019-00656-x

Title: Change in Prescribing forSecondary Prevention of Stroke and Coronary Heart Disease in Finnish Nursing Homes and Assisted Living Facilities
Author: Jokanovic, Natali; Kautiainen, Hannu; Bell, J. Simon; Tan, Edwin C. K.; Pitkälä, Kaisu H.
Contributor: University of Helsinki, Clinicum
University of Helsinki, Department of General Practice and Primary Health Care
Date: 2019-06
Language: eng
Number of pages: 9
Belongs to series: Drugs & Aging
ISSN: 1170-229X
URI: http://hdl.handle.net/10138/316131
Abstract: BackgroundOne quarter of residents in long-term care facilities (LTCFs) have a diagnosis of CHD or stroke and over half use at least one preventative cardiovascular medication. There have been no studies that have investigated the longitudinal change in secondary preventative cardiovascular medication use in residents in LTCFs over time.ObjectiveThe aim of this study was to investigate the change in cardiovascular medication use among residents with coronary heart disease (CHD) and prior stroke in nursing homes (NHs) and assisted living facilities (ALFs) in Finland over time, and whether this change differs according to dementia status.MethodsThree comparable cross-sectional audits of cardiovascular medication use among residents aged 65years and over with CHD or prior stroke in NHs in 2003 and 2011 and ALFs in 2007 and 2011 were compared. Logistic regression analyses adjusted for gender, age, mobility, cancer and length of stay were performed to examine the effect of study year, dementia and their interaction on medication use.ResultsCardiovascular medication use among residents with CHD (NHs: 89% vs 70%; ALFs: 89% vs 84%) and antithrombotic medication use among residents with stroke (NHs: 72% vs 63%; ALFs: 78% vs 69%) declined between 2003 and 2011 in NHs and 2007 and 2011 in ALFs.Decline in the use of diuretics, nitrates and digoxin were found in both groups and settings. Cardiovascular medication use among residents with CHD and dementia declined in NHs (88% [95% CI 85-91] in 2003 vs 70% [95% CI 64-75] in 2011) whereas there was no change among people without dementia. There was no change in cardiovascular medication use among residents with CHD in ALFs with or without dementia over time. Antithrombotic use was lower in residents with dementia compared with residents without dementia in NHs (p
Subject: CARDIOVASCULAR MEDICATION USE
SECONDARY PREVENTION
ESC GUIDELINES
OLDER-ADULTS
RESIDENTS
DEMENTIA
CARE
MANAGEMENT
RISK
MALNUTRITION
3121 Internal medicine
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