title: Underexposure of Seniors to Heart Failure Drug Therapy.
abstract: BACKGROUND
  Little is known about exposure to heart failure (HF) treatment among seniors with ischemic heart disease.
  
  
  OBJECTIVE
  In a population of seniors, we: 1) estimated the association between age and exposure to HF drug therapy at 6, 12, 36 and 60 month intervals after HF diagnosis, and 2) determined the influence of the passage of time on exposure to drug therapy.
  
  
  METHODS
  Using the Quebec provincial administrative databases, we conducted a population-based inception cohort study that included all individuals aged ≥ 65 with a first HF diagnosis between 2000 and 2009 and an ischemic heart disease diagnosis in the year before HF diagnosis. We assessed exposure to HF drug therapy and to drug therapy at target doses at 6, 12, 36 and 60 month intervals after HF diagnosis. Adjusted prevalence ratios (aPR) between age at diagnosis and exposure to drug therapy and the influence of time (6-month periods) were assessed using multivariate modified Poisson regressions.
  
  
  RESULTS
  Among the 86,428 seniors, those who were older were less likely to be exposed to both HF drug therapy and drug therapy at target doses at each time point, than were the younger ones (aged 65-69). The aPRs for exposure to drug therapy for the 90+ age group were 0.64, 0.64, 0.56 and 0.53 at the 6, 12, 36 and 60 month intervals, respectively. After HF diagnosis, exposure increased by a maximum of 8% per 6-month period.
  
  
  CONCLUSIONS
  Increasing age is associated with a decrease in exposure to drug therapy, with only slight improvement in exposure after HF diagnosis.
authors.forename: C
authors.initials: C
authors.lastname: Girouard
authors.forename: J-P
authors.initials: JP
authors.lastname: Gregoire
authors.forename: J-F
authors.initials: JF
authors.lastname: Kayibanda
authors.forename: P
authors.initials: P
authors.lastname: Poirier
authors.forename: E
authors.initials: E
authors.lastname: Demers
authors.forename: J
authors.initials: J
authors.lastname: Moisan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D011792:Quebec / Q000453:epidemiology
chemical_list: D002317:Cardiovascular Agents