title: Changes in cholesterol-lowering medications use over a decade in community-dwelling older adults.
abstract: BACKGROUND
  The impact of evidence-based guidelines and controlled trial data on use of cholesterol-lowering medications in older adults is unclear.
  
  
  OBJECTIVE
  To examine whether utilization patterns of cholesterol-lowering medications in community-dwelling older adults changed following the release of the National Cholesterol Education Program Adult Treatment Panel III guidelines and results from the Prospective Study of Pravastatin in the Elderly at Risk in 2002.
  
  
  METHODS
  Community-dwelling elderly individuals who were enrolled in the Health, Aging and Body Composition Study in 1997-1998 were followed for up to 11 years. An interrupted time series analysis with multivariable generalized estimating equations (GEEs) was used to examine changes in level and trend in cholesterol-lowering medication use before and after 2002, adjusting for sociodemographics, health-related behaviors, and health status.
  
  
  RESULTS
  Cholesterol-lowering medication use increased nearly 3-fold from 14.9% in 1997-1998 to 42.6% in 2007-2008, with statins representing the most common class used (87-94%). Multivariable GEE results revealed no significant difference in the level of cholesterol-lowering medication use after 2002 (adjusted OR 0.95; 95% CI 0.89-1.02). Multivariable GEE results revealed that trend changes in the rate of increase in cholesterol-lowering medication declined after 2002 (adjusted ratio of ORs 0.92; 95% CI 0.89-0.95).
  
  
  CONCLUSIONS
  The use of cholesterol-lowering medication increased substantially over a decade in community-dwelling elderly individuals but was not related to a change in level or trend following the release of the guidelines and evidence-based data.
authors.affiliation: School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Wei-Hsuan
authors.initials: WH
authors.lastname: Lo-Ciganic
authors.forename: Robert M
authors.initials: RM
authors.lastname: Boudreau
authors.forename: Shelly L
authors.initials: SL
authors.lastname: Gray
authors.forename: Janice C
authors.initials: JC
authors.lastname: Zgibor
authors.forename: Julie M
authors.initials: JM
authors.lastname: Donohue
authors.forename: Subashan
authors.initials: S
authors.lastname: Perera
authors.forename: Anne B
authors.initials: AB
authors.lastname: Newman
authors.forename: Eleanor M
authors.initials: EM
authors.lastname: Simonsick
authors.forename: Douglas C
authors.initials: DC
authors.lastname: Bauer
authors.forename: Suzanne
authors.initials: S
authors.lastname: Satterfield
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Hanlon
mesh_terms: D000367:Age Factors; D000368:Aged; D002784:Cholesterol / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000097:blood* / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D017410:Practice Guidelines as Topic / Q000592:standards*; D011446:Prospective Studies; D012111:Residence Characteristics; D013997:Time Factors
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002784:Cholesterol