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Use of evidence- based therapy for the prevention of cardiovascular events among older people


Castelino, RL and Chen, TF and Guddattu, V and Bajorek, BV, Use of evidence- based therapy for the prevention of cardiovascular events among older people, Evaluation and The Health Professions, 33, (3) pp. 276-301. ISSN 0163-2787 (2006) [Refereed Article]

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Copyright 2006 Sage Publications

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Abstract Evidence-based therapies (EBTs) for the prevention of cardiovascular disease (CVD) are reportedly underutilized in older people. The primary purpose of this study was to evaluate the use of EBTs for the prevention of CVD events in older people and secondarily whether a Home Medicines Review (HMR) service by pharmacists’ predicts the use of these medicines. A retrospective cross-sectional audit of HMR reports pertaining to 608 community-dwelling older people (65 years) was conducted. EBTs considered for this audit included four guideline-recommended therapies for CVD: antithrombotic therapy (warfarin+antiplatelet therapy), b-blockers, statins, and angiotensin agents (angiotensin-converting enzyme inhibitors [ACEI]+angiotensin II receptor blockers [ARBs]). The prevalence of EBT use among the older people, mean age (SD) 75.6 (7.5) years, was: 73% for antithrombotic therapy, 75% for statins, 74% for angiotensin therapy, and 35% for b-blockers. CVD risk factors warranting treatment with these EBTs were frequently associated with use of EBTs. EBTs were least likely to be used in those with coronary interventions like coronary artery bypass grafting (CABG)/stent insertion (all EBTs except angiotensin agents) and angiotensin agents in those with a history of myocardial infarction or chronic heart failure. A pharmacist-led HMR service was significantly associated with the prescribing of all 4 EBTs. The results from this study show good adherence to evidence-based guidelines in general, although there is still room for improvement to further optimize clinical outcomes in these complex patients. The study also adds to the available literature on the effectiveness of pharmacists’ collaborative contribution to the care of these high-risk patients.

Item Details

Item Type:Refereed Article
Keywords:Evidence-based Therapies, Home Medicines, Reviews
Research Division:Biomedical and Clinical Sciences
Research Group:Pharmacology and pharmaceutical sciences
Research Field:Clinical pharmacy and pharmacy practice
Objective Division:Health
Objective Group:Other health
Objective Field:Other health not elsewhere classified
UTAS Author:Castelino, RL (Dr Ronald Castelino)
ID Code:86273
Year Published:2006
Deposited By:Pharmacy
Deposited On:2013-09-02
Last Modified:2014-04-17

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