Suboptimal Use of Cardioprotective Drugs in Newly Treated Elderly Individuals With Type 2 Diabetes
- Caroline Sirois, BPHARM, MSC123,
- Jocelyne Moisan, PHD12,
- Paul Poirier, MD, PHD14 and
- Jean-Pierre Grégoire, MPH, PHD12
- 1Faculty of Pharmacy, Laval University, Quebec, Canada
- 2Population Health Research Unit, Centre Hospitalier Affilié Universitaire de Québec, Quebec, Canada
- 3Institut National de Santé Publique du Québec, Quebec, Canada
- 4Quebec Heart Institute, Laval Hospital, Quebec, Canada
- Address correspondence and reprint requests to Jean-Pierre Grégoire, Population Health Research Unit, Centre Hospitalier Affilié Universitaire de Québec, 1050, Chemin Sainte-Foy, Québec, Quebec City, Canada, G1S 4L8. E-mail: jean-pierre.gregoire{at}pha.ulaval.ca
Cardiovascular disease is the main complication experienced by elderly individuals with diabetes (1). Despite randomized trials showing the benefits of individual (2–4) or combined (5) pharmacological treatments of cardiovascular risk factors in diabetes, observational studies have shown suboptimal use of medications (6–8). However, little is known about the use of cardioprotective medication among elderly individuals who were not already taking it before diabetes treatment was undertaken. We therefore studied a population of elderly individuals with type 2 diabetes in the province of Quebec, Canada, who had not been treated with any antihypertensive, lipid-lowering, or antiplatelet drugs in the year before oral antidiabetes drug initiation. We assessed whether they used a comprehensive cardioprotective regimen (CCR) of those three medications in the year following oral antidiabetic initiation. We also identified the determinants of a CCR use.
RESEARCH DESIGN AND METHODS—
We carried out a population-based inception cohort study using the Quebec Diabetes Surveillance System, which is the product of linking public health administrative databases managed by the Quebec Health Insurance Board. It includes information on patient demographics, physician and hospital services, and data from the public drug plan for individuals who had been diagnosed with diabetes.
We selected individuals aged ≥66 years who had initiated an oral antidiabetes medication treatment between 1 January 1998 and 31 December 2002. The date of the first claim was the index date. We excluded individuals who had …
