AimsAntiplatelet therapy is recommended for the secondary prevention of cardio- and cerebrovascular disease, but for primary prevention it is advised only in patients at very high risk. With this background, this study aims to assess the appropriateness of antiplatelet therapy in acutely hospitalized older people according to their risk profile.MethodsData were obtained from the REPOSI register held in Italian and Spanish internal medicine and geriatric wards in 2012 and 2014. Hospitalized patients aged 65 assessable at discharge were selected. Appropriateness of the antiplatelet therapy was evaluated according to their primary or secondary cardiovascular prevention profiles.ResultsOf 2535 enrolled patients, 2199 were assessable at discharge. Overall 959 (43.6%, 95% CI 41.5-45.7) were prescribed an antiplatelet drug, aspirin being the most frequently chosen. Among patients prescribed for primary prevention, just over half were inappropriately prescribed (52.1%), being mainly overprescribed (155/209 patients, 74.2%). On the other hand, there was also a high rate of inappropriate underprescription in the context of secondary prevention (222/726 patients, 30.6%, 95% CI 27.3-34.0%).ConclusionsThis study carried out in acutely hospitalized older people shows a high degree of inappropriate prescription among patients prescribed with antiplatelets for primary prevention, mainly due to overprescription. Further, a large proportion of patients who had had overt cardio- or cerebrovascular disease were underprescribed, in spite of the established benefits of antiplatelet drugs in the context of secondary prevention.
Appropriateness of antiplatelet therapy for primary and secondary cardio‐ and cerebrovascular prevention in acutely hospitalized older people / Ilaria, Ardoino; Raffaella, Rossio; Donnatella, Di Blanca; Alessandro, Nobili; Luca, Pasina; Pier Mannuccio, Mannucci; Flora, Peyvandi; Carlotta, Franchi; Prisco, Domenico; Silvestri, Elena; Cenci, Caterina; Barnini, Tommaso; Delitala, Giuseppe; Carta, Stefano; Atzori, Sebastiana; Guarnieri, Gianfranco; Zanetti, Michela; Spalluti, Annalisa; Grazia Serra, Maria; Antonietta Bleve, Maria; Vanoli, Massimo; Grignani, Giulia; Casella, Gianluca; Gasbarrone, Laura; Maniscalco, Giorgio; Gunelli, Massimo; Tirotta, Daniela; Brucato, Antonio; Ghidoni, Silvia; Di Corato, Paola; Bernardi, Mauro; Li Bassi, Silvia; Santi, Luca; Agnelli, Giancarlo; Iorio, Alfonso; Marcucci, Maura; Marchesini, Emanuela; Mannarino, Elmo; Lupattelli, Graziana; Rondelli, Pamela; Paciullo, Francesco; Fabris, Fabrizio; Carlon, Michela; Turatto, Francesca; Cristina Baroni, Maria; Zardo, Marianna; Manfredini, Roberto; Molino, Christian; Pala, Marco; Fabbian, Fabio; Nuti, Ranuccio; Valenti, Roberto; Ruvio, Martina; Cappelli, Silvia; Paolisso, Giuseppe; Rosaria Rizzo, Maria; Teresa Laieta, Maria; Salvatore, Teresa; Carlo Sasso, Ferdinando; Utili, Riccardo; Durante Mangoni, Emanuele; Pinto, Daniela; Olivieri, Oliviero; Maria Stanzial, Anna; Fellin, Renato; Volpato, Stefano; Fotini, Sioulis; Barbagallo, Mario; Dominguez, Ligia; Plances, Lidia; D'Angelo, Daniela; Rini, Giovanbattista; Mansueto, Pasquale; Pepe, Ilenia; Licata, Giuseppe; Calvo, Luigi; Valenti, Maria; Borghi, Claudio; Strocchi, Enrico; Rebecca Rinaldi, Elisa; Zoli, Marco; Fabbri, Elisa; Magalotti, Donatella; Auteri, Alberto; Laura Pasqui, Anna; Puccetti, Luca; Laghi Pasini, Franco; Leopoldo Capecchi, Pier; Bicchi, Maurizio; Sabbà, Carlo; Saverio Vella, Francesco; Marseglia, Alessandro; Valentina Luglio, Chiara; Palasciano, Giuseppe; Ester Modeo, Maria; Aquilino, Annamaria; Raffaele, Pallante; Pugliese, Stefania; Capobianco, Caterina; Postiglione, Alfredo; Rosaria Barbella, Maria; De Stefano, Francesco; Fenoglio, Luigi; Brignone, Chiara; Bracco, Christian; Giraudo, Alessia; Musca, Giuseppe; Cuccurullo, Olga; Cricco, Luigi; Fiorentini, Alessandra; Domenica Cappellini, Maria; Fabio, Giovanna; Seghezzi, Sonia; Migone De Amicis, Margherita; Fargion, Silvia; Bonara, Paola; Bulgheroni, Mara; Lombardi, Rosa; Magrini, Fabio; Massari, Ferdinando; Tonella, Tatiana; Peyvandi, Flora; Tedeschi, Alberto; Monzani, Valter; Savojardo, Valeria; Folli, Christian; Magnini, Maria; Mari, Daniela; Dionigi Rossi, Paolo; Damanti, Sarah; Prolo, Silvia; Sole Lilleri, Maria; Cricco, Luigi; Fiorentini, Alessandra; Micale, Giuliana; Podda, Mauro; Selmi, Carlo; Francesca, ; Salerno, Francesco; Accordino, Silvia; Conca, Alessio; Monti, Valentina; Roberto Corazza, Gino; Miceli, Emanuela; Vincenzo Lenti, Marco; Padula, Donatella; Balduini, Carlo L.; Bertolino, Giampiera; Provini, Stella; Quaglia, Federica; Murialdo, Giovanni; Bovio, Marta; Dallegri, Franco; Ottonello, Luciano; Quercioli, Alessandra; Barreca, Alessandra; Beatrice Secchi, Maria; Ghelfi, Davide; Sheng Chin, Wu; Carassale, Laura; Caporotundo, Silvia; Anastasio, Luigi; Sofia, Lucia; Carbone, Maria; Traisci, Giancarlo; De Feudis, Lucrezia; Di Carlo, Silvia; Davì, Giovanni; Teresa Guagnano, Maria; Sestili, Simona; Bergami, Elisabetta; Rizzioli, Emanuela; Cagnoni, Carlo; Bertone, Luca; Manucra, Antonio; Buratti, Alberto; Tognin, Tiziana; Lucio Liberato, Nicola; Bernasconi, Giordano; Nardo, Barbara; Battista Bianchi, Giovanni; Giaquinto, Sabrina; Benetti, Giampiero; Quagliolo, Michela; Riccardo Centenaro, Giuseppe; Purrello, Francesco; Di Pino, Antonino; Piro, Salvatore; Mancuso, Gerardo; Calipari, Daniela; Bartone, Mosè; Gullo, Francesco; Cortellaro, Michele; Magenta, Marina; Perego, Francesca; Rachele Meroni, Maria; Cicardi, Marco; Gidaro Marina Magenta, Antonio; Sacco, Andrea; Bonelli, Antonio; Dentamaro, Gaetano; Rozzini, Renzo; Falanga, Lina; Giordano, Alessandro; Cavallo Perin, Paolo; Lorenzati, Bartolomeo; Gruden, Gabriella; Bruno, Graziella; Greco, Elisabetta; Tizzani, Pietro; Fera, Giacomo; Loreta Di Luca, Maria; Renna, Donatella; Perciccante, Antonio; Coralli, Alessia; Tassara, Rodolfo; Melis, Deborah; Rebella, Lara; Menardo, Giorgio; Bottone, Stefania; Sferrazzo, Elsa; Ferri, Claudio; Striuli, Rinaldo; Scipioni, Rosa; Salmi, Raffaella; Gaudenzi, Piergiorgio; Gamberini, Susanna; Ricci, Franco; Morabito, Cosimo; Fava, Roberto; Semplicini, Andrea; Gottardo, Lucia; Delitala, Giuseppe; Carta, Stefano; Atzori, Sebastiana; Vendemiale, Gianluigi; Serviddio, Gaetano; Forlano, Roberta; Bolondi, Luigi; Rasciti, Leonardo; Serio, Ilaria; Masala, Cesare; Mammarella, Antonio; Raparelli, Valeria; Rossi Fanelli, Filippo; Delfino, Massimo; Amoroso, Antonio; Violi, Francesco; Basili, Stefania; Perri, Ludovica; Serra, Pietro; Fontana, Vincenzo; Falcone, Marco; Landolfi, Raffaele; Grieco, Antonio; Gallo, Antonella; Zuccalà, Giuseppe; Franceschi, Francesco; De Marco, Guido; Chiara, Cordischi; Marta, Sabbatini; Bellusci, Martino; Setti, Donatella; Pedrazzoli, Filippo; Romanelli, Giuseppe; Pirali, Caterina; Amolini, Claudia; Agabiti Rosei, Enrico; Rizzoni, Damiano; Castoldi, Luana; Picardi, Antonio; Vespasiani, Umberto; Gentilucci, ; Mazzarelli, Chiara; Gallo, Paolo; Guasti, Luigina; Castiglioni, Luana; Maresca, Andrea; Squizzato, Alessandro; Contini, Sara; Molaro, Marta; Annoni, Giorgio; Corsi Sara Zazzetta, Maurizio; Bertolotti, Marco; Mussi, Chiara; Scotto, Roberto; Alice Ferri, Maria; Veltri, Francesca; Arturi, Franco; Succurro, Elena; Sesti, Giorgio; Gualtieri Francesco Perticone, Umberto; Sciacqua, Angela; Quero, Michele; Bagnato, Chiara; Loria, Paola; Angela Becchi, Maria; Martucci, Gianfranco; Fantuzzi, Alessandra; Maurantonio, Mauro; Corinaldesi, Roberto; De Giorgio, Roberto; Serra, Mauro; Grasso, Valentina; Ruggeri, Eugenio; Mauro Carozza, Lorenzo; Pignatti., Fabio. - In: BRITISH JOURNAL OF CLINICAL PHARMACOLOGY. - ISSN 0306-5251. - 83:11(2017), pp. 2528-2540. [10.1111/bcp.13355]
Appropriateness of antiplatelet therapy for primary and secondary cardio‐ and cerebrovascular prevention in acutely hospitalized older people
Francesco Paciullo;Sarah Damanti;
2017-01-01
Abstract
AimsAntiplatelet therapy is recommended for the secondary prevention of cardio- and cerebrovascular disease, but for primary prevention it is advised only in patients at very high risk. With this background, this study aims to assess the appropriateness of antiplatelet therapy in acutely hospitalized older people according to their risk profile.MethodsData were obtained from the REPOSI register held in Italian and Spanish internal medicine and geriatric wards in 2012 and 2014. Hospitalized patients aged 65 assessable at discharge were selected. Appropriateness of the antiplatelet therapy was evaluated according to their primary or secondary cardiovascular prevention profiles.ResultsOf 2535 enrolled patients, 2199 were assessable at discharge. Overall 959 (43.6%, 95% CI 41.5-45.7) were prescribed an antiplatelet drug, aspirin being the most frequently chosen. Among patients prescribed for primary prevention, just over half were inappropriately prescribed (52.1%), being mainly overprescribed (155/209 patients, 74.2%). On the other hand, there was also a high rate of inappropriate underprescription in the context of secondary prevention (222/726 patients, 30.6%, 95% CI 27.3-34.0%).ConclusionsThis study carried out in acutely hospitalized older people shows a high degree of inappropriate prescription among patients prescribed with antiplatelets for primary prevention, mainly due to overprescription. Further, a large proportion of patients who had had overt cardio- or cerebrovascular disease were underprescribed, in spite of the established benefits of antiplatelet drugs in the context of secondary prevention.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
