Exposure to statins is associated to fracture risk reduction in elderly people with cardiovascular disease: evidence from the <scp>AIFA</scp>‐<scp>I‐GrADE</scp> observational project

Rea, Federico; Bonassi, Stefano; Vitale, Cristiana; Trifirò, Gianluca; Cascini, Silvia; Roberto, Giuseppe; Chinellato, Alessandro; Lucenteforte, Ersilia; Mugelli, Alessandro; Corrao, Giovanni

doi:10.1002/pds.4206

Cited by 15 publications

(22 citation statements)

References 47 publications

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“…Our data additionally support this hypothesis showing that, after excluding the lowest exposure class with PDD ranging between 0% and 20% of DDD, there is a trend to a progressively increasing effect by statins in reducing the rate of hospitalizations due to infections. We have, in fact, been able to compute the NNT to prevent 1 hospitalization translating into values ranging from 54 in PDD class 80% to 100% to 89 in 20% to 50% class, thus completely across the mean range of compliance to statin therapy as reported in similar populations of Italian territorial units . Our data suggest that statin effect on hospitalization rate for infections is directly associated to drug dose as well as to background population risk factors linked to prevailing statin therapy.…”

Section: Discussionmentioning

confidence: 56%

Effect of statins in preventing hospitalizations for infections: A population study

Policardo¹,

Seghieri²,

Gualdani³

et al. 2018

Pharmacoepidemiology and Drug

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Compliance to statin prescribed daily doses above the threshold 20% of DDD, along a 5-year follow-up, prevented hospitalizations due to infectious diseases in a large unselected population, after adjusting for covariates able to modulate baseline risk of infections. The NNTs to avoid 1 hospitalization for infections resulted on average not too dissimilar from a value lying between the 95% CI of NNTs previously found for primary prevention of 1 incident coronary ischemic event (72 to 119).

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Section: Discussionmentioning

confidence: 56%

Effect of statins in preventing hospitalizations for infections: A population study

Policardo¹,

Seghieri²,

Gualdani³

et al. 2018

Pharmacoepidemiology and Drug

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“…The included studies focussed on a wide range of disease areas including pulmonary diseases, osteoporosis, depression, cardiovascular diseases, Parkinson's disease, epilepsy, chronic kidney disease, cancer and diabetes mellitus . Two studies did not measure disease‐specific medication (non‐)adherence .…”

Section: Resultsmentioning

confidence: 99%

“…Two studies did not measure disease‐specific medication (non‐)adherence . Thirty‐six studies were specific to, or provided age stratified analysis for people aged ≥64 years, while the other 30 studies also included middle aged adults (≥50 years) . Thirteen authors of the included texts were contacted via e‐mail for further information, and 8 replied.…”

Section: Resultsmentioning

confidence: 99%

“…Thirteen authors of the included texts were contacted via e‐mail for further information, and 8 replied. In terms of adherence measurement, 54 studies measured medication (non‐)adherence using pharmacy claims data while 11 studies used self‐report methods, consisting of the 4‐item or 8‐item Morisky Medication Adherence Scale, or self‐reported PDC and MEMs was used in 4 studies …”

Section: Resultsmentioning

confidence: 99%

“…Overall, 48 studies were determined to be high quality, 17 were determined to be medium quality and 1 study was deemed to be low quality (Table S8). There was considerable variability with regards to external validity (generalisability), with 15 studies deemed medium quality and 11 studies achieving low quality . This was due to lack of detail on sampling or recruitment procedures or inclusion of specific populations only.…”

Section: Resultsmentioning

confidence: 99%

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The association between medication non‐adherence and adverse health outcomes in ageing populations: A systematic review and meta‐analysis

Walsh

Cahir

Tecklenborg

et al. 2019

Brit J Clinical Pharma

139

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Aims The aim of this systematic review and meta‐analysis was to synthesise the evidence relating to medication non‐adherence and its association with health outcomes in people aged ≥50 years. Methods Seven databases were searched up to February 2019 for observational studies that measured medication (non‐)adherence as a predictor of the following health outcomes in adults aged ≥50 years: healthcare utilisation (hospitalisation, emergency department visits, outpatient visits and general practitioner visits), mortality, adverse clinical events and quality of life. Screening and quality assessment using validated criteria were completed by 2 reviewers independently. Random effects models were used to generate pooled estimates of association using adjusted study results. The full methodological approach was published on PROSPERO (ID: CRD42017077264). Results Sixty‐six studies were identified for qualitative synthesis, with 11 of these studies eligible for meta‐analyses. A meta‐analysis including 3 studies measuring medication non‐adherence in adults aged ≥55 years showed a significant association with all‐cause hospitalisation (adjusted odds ratio 1.17, 95% confidence interval [CI] 1.12, 1.21). A meta‐analysis including 2 studies showed that medication non‐adherence was not significantly associated with an emergency department visit (adjusted odds ratio 1.05, 95% CI 0.90, 1.22). Good adherence was associated with a 21% reduction in long‐term mortality risk in comparison to medication non‐adherence (adjusted hazard ratio 0.79, 95% CI 0.63, 0.98). Conclusion Medication non‐adherence may be significantly associated with all‐cause hospitalisation and mortality in older people. Medication adherence should be monitored and addressed in this cohort to minimise hospitalisation, improve clinical outcomes and reduce healthcare costs.

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Quality of reporting of drug exposure in pharmacoepidemiological studies

Hempenius

Luijken

Boer

et al. 2020

Pharmacoepidemiology and Drug

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Purpose Exposure definitions vary across pharmacoepidemiological studies. Therefore, transparent reporting of exposure definitions is important for interpretation of published study results. We aimed to assess the quality of reporting of exposure to identify where improvement may be needed. Method We systematically reviewed observational pharmacoepidemiological studies that used routinely collected health data, published in 2017 in six pharmacoepidemiological journals. Reporting of exposure was scored using 11 items of the ISPE‐ISPOR guideline on reporting of pharmacoepidemiological studies. Results Of the 91 studies included, all studies reported the type of exposure (100%), while most reported the exposure risk window (85%) and the exposure assessment window (98%). Operationalization of the exposure window was described infrequently: 16% (14/90) of the studies explicitly reported the presence or absence of an induction period if applicable, 11% (5/47), and 35% (17/49) reported how stockpiling and gaps between exposure episodes were handled, respectively, and 35% (17/49) explicitly mentioned the exposure extension. Switching/add‐on was reported in 62% (50/81). How switching between drugs was dealt with and specific drug codes were reported in 52 (57%) and 24 (26%) studies, respectively. Conclusion Publications of pharmacoepidemiological studies frequently reported the type of exposure, the exposure risk window, and the exposure assessment window. However, more details on exposure assessment are needed, especially when it concerns the operationalization of the exposure risk window (eg, the presence or absence of an induction period or exposure extension, handling of stockpiling and gaps, and specific codes), to allow for correct interpretation, reproducibility, and assessment of validity.

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Exposure to statins is associated to fracture risk reduction in elderly people with cardiovascular disease: evidence from the AIFA‐I‐GrADE observational project

Abstract: Use of statins for secondary cardiovascular prevention is associated with fracture risk reduction in elderly people. Further studies are required to better clarify the statin-fracture association in postmenopausal women. Copyright © 2017 John Wiley & Sons, Ltd.

Cited by 15 publications

References 47 publications

Effect of statins in preventing hospitalizations for infections: A population study

Effect of statins in preventing hospitalizations for infections: A population study

The association between medication non‐adherence and adverse health outcomes in ageing populations: A systematic review and meta‐analysis

Quality of reporting of drug exposure in pharmacoepidemiological studies

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