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Titolo:
Paradoxical relations of drug treatment with mortality in older persons
Autore:
Glynn, RJ; Knight, EL; Levin, R; Avorn, J;
Indirizzi:
Brigham & Womens Hosp, Div Pharmacoepidemiol & Pharmacoecon, Boston, MA 02115 USA Brigham & Womens Hosp Boston MA USA 02115 rmacoecon, Boston, MA 02115 USA Brigham & Womens Hosp, Div Prevent Med, Boston, MA 02115 USA Brigham & Womens Hosp Boston MA USA 02115 event Med, Boston, MA 02115 USA Harvard Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02115 USA Harvard Univ Boston MA USA 02115 Hlth, Dept Biostat, Boston, MA 02115 USA
Titolo Testata:
EPIDEMIOLOGY
fascicolo: 6, volume: 12, anno: 2001,
pagine: 682 - 689
SICI:
1044-3983(200111)12:6<682:PRODTW>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE MYOCARDIAL-INFARCTION; CHRONIC DISEASE SCORE; AUTOMATED PHARMACY DATA; DIABETES-MELLITUS; RISK FACTOR; AGE; HYPERTENSION; COMORBIDITY; ADHERENCE; THERAPY;
Keywords:
aging; bias; confounding; pharmacoepidemiology; prescribing;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
38
Recensione:
Indirizzi per estratti:
Indirizzo: Glynn, RJ Brigham & Womens Hosp, Div Pharmacoepidemiol & Pharmacoecon, 221Longwood Ave,BL1 341, Boston, MA 02115 USA Brigham & Womens Hosp 221 Longwood Ave,BL1 341 Boston MA USA 02115
Citazione:
R.J. Glynn et al., "Paradoxical relations of drug treatment with mortality in older persons", EPIDEMIOLOG, 12(6), 2001, pp. 682-689

Abstract

Medication use patterns provide popular surrogate measures of disease, yetselective under-use of drugs by elderly patients with potentially unmeasured comorbidity may lead to artifactual "protective" associations between use of specific drugs and mortality. We examined the relation between use of 20 common classes of drugs and mortality among the 129,111 residents of NewJersey 65-99 years of age who had at least one hospitalization during the years 1991-1994 and filled prescriptions through either Medicaid or that state's Pharmacy Assistance for the Aged and Disabled program. Each study drug class was used by more than 5,000 subjects during the 120 days before hospitalization; 41,930 subjects died in the hospital or during the year afterdischarge. Users of drugs from each of seven therapeutic classes had reduced age- and sex-adjusted rates of death relative to non-users: lipid-lowering agents, nonsteroidal anti-inflammatory agents, beta blockers, thiazides,glaucoma drugs, calcium channel blockers, and antianxiety drugs. Adjustment for comorbidity and polypharmacy had tittle effect on these results. We found similar results in a separate nonhospitalized cohort of 132,071 elderly persons. Much of this observed association appears to be nonetiologic. These findings raise concerns about using observational studies in high-risk populations to infer associations between drug use and outcomes.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/01/20 alle ore 22:06:40