ABSTRACT
Title
“Fiesole Misurata” database: an ongoing project to investigate how to enhance adherence to antihypertensive medications
Authors
E. Lucenteforte1, R. Bonaiuti1, V. Maggini1, A. Pugi1, M. Moschini1, M. Di Pirro1, M. Taras2, A. Barchielli3, M. Belladonna4, N. Nesti4, A. Ungar4, A. Mugelli1, A. Vannacci1, F. Lapi1
1. Dipartimento di Farmacologia Preclinica e Clinica “M. Aiazzi Mancini”, Università di Firenze
2. Comune di Fiesole, Assessorato ai servizi sociali
3. Osservatorio di Epidemiologia, Agenzia Regionale di Sanità della Toscana
4. Unità di Medicina e Cardiologia Geriatria, Dipartimento del Cuore e dei Vasi, Università di Firenze e Azienda Ospedaliero - Universitaria Careggi
1. Dipartimento di Farmacologia Preclinica e Clinica “M. Aiazzi Mancini”, Università di Firenze
2. Comune di Fiesole, Assessorato ai servizi sociali
3. Osservatorio di Epidemiologia, Agenzia Regionale di Sanità della Toscana
4. Unità di Medicina e Cardiologia Geriatria, Dipartimento del Cuore e dei Vasi, Università di Firenze e Azienda Ospedaliero - Universitaria Careggi
Abstract
Introduction: Non-adherence to antihypertensive medications(AM) is a major concern in the elderly. Up to 50% of AM recipients discontinued therapy during the first six months.
Aim: The aim of the project “Fiesole Misurata” was to investigate the possible strategies to reduce non-adherence to AM among older community dwellers. In the first phase of the project, we evaluated database in terms of validation and generalization of information about cardiovascular diseases, medications, and other selected characteristics.
Methods: Fiesole, a small town near Florence, included 2,228 subjects aged 65 years or more. Reimbursed prescriptions (ATC codes) and discharge diagnoses (ICD9CM codes), between 1st of January 2008 and 31st July 2010, were retrieved from the Local Health Authority claim repository. All records were merged through an encrypted ID code. A sub-cohort (n=385) of residents of Fiesole were enrolled between 10th May and 15th July 2010. All participants received written and oral information about the study and written informed consent was obtained. Data were collected by means of a semi-structured questionnaire administered by trained pharmacists and geriatricians using a face-to-face interview as well as a by means of a multidimensional geriatric evaluation. The questionnaire included socio-demographic characteristics (age, gender, education, and occupation), anthropometric measures, selected lifestyle habits including tobacco smoking and alcohol consumption, a validated food-frequency section, use of antihypertensive drugs, and a detailed medical history including cardiovascular disease. Disability (BADL) and cognitive status (MMSE) and mood disorders (GDS scale) were also collected. “Fiesole Misurata” was composed by a claim and a cross-sectional (CS) dataset.
Results: Subjects were mainly females (57% in both claim and CS databases), the mean age was 73 ± 7.7 in claim database and 76 ± 7.1 in CS one. In both claim and CS databases, 64% of subjects were AM users, and ACE inhibitors were the most used drugs (36 % in claim database, 45 % in CS) followed by beta-blockers (26 and 25, respectively). Prevalence of hospitalization for ischemic cardiomiopathy, stroke and heart failure was 2.2, 0.5, and 1.4%, , in claim database, and 11.2, 7.1 and 6.7%, in CS one. Moreover, almost half of subjects (48%) had an optimal or normal blood pressure and less than one-third (27%) was disable according to BADL scale; most of enrollees (89%) had a good cognitive status, and almost one-fifth (20%) were depressed according to GDS score.
Conclusions: On the basis of medical literature, “Fiesole Misurata” database seems to possess valid and generalizable information in terms of cardiovascular diseases, medications, and other clinical features.
Aim: The aim of the project “Fiesole Misurata” was to investigate the possible strategies to reduce non-adherence to AM among older community dwellers. In the first phase of the project, we evaluated database in terms of validation and generalization of information about cardiovascular diseases, medications, and other selected characteristics.
Methods: Fiesole, a small town near Florence, included 2,228 subjects aged 65 years or more. Reimbursed prescriptions (ATC codes) and discharge diagnoses (ICD9CM codes), between 1st of January 2008 and 31st July 2010, were retrieved from the Local Health Authority claim repository. All records were merged through an encrypted ID code. A sub-cohort (n=385) of residents of Fiesole were enrolled between 10th May and 15th July 2010. All participants received written and oral information about the study and written informed consent was obtained. Data were collected by means of a semi-structured questionnaire administered by trained pharmacists and geriatricians using a face-to-face interview as well as a by means of a multidimensional geriatric evaluation. The questionnaire included socio-demographic characteristics (age, gender, education, and occupation), anthropometric measures, selected lifestyle habits including tobacco smoking and alcohol consumption, a validated food-frequency section, use of antihypertensive drugs, and a detailed medical history including cardiovascular disease. Disability (BADL) and cognitive status (MMSE) and mood disorders (GDS scale) were also collected. “Fiesole Misurata” was composed by a claim and a cross-sectional (CS) dataset.
Results: Subjects were mainly females (57% in both claim and CS databases), the mean age was 73 ± 7.7 in claim database and 76 ± 7.1 in CS one. In both claim and CS databases, 64% of subjects were AM users, and ACE inhibitors were the most used drugs (36 % in claim database, 45 % in CS) followed by beta-blockers (26 and 25, respectively). Prevalence of hospitalization for ischemic cardiomiopathy, stroke and heart failure was 2.2, 0.5, and 1.4%, , in claim database, and 11.2, 7.1 and 6.7%, in CS one. Moreover, almost half of subjects (48%) had an optimal or normal blood pressure and less than one-third (27%) was disable according to BADL scale; most of enrollees (89%) had a good cognitive status, and almost one-fifth (20%) were depressed according to GDS score.
Conclusions: On the basis of medical literature, “Fiesole Misurata” database seems to possess valid and generalizable information in terms of cardiovascular diseases, medications, and other clinical features.