{"id":6375,"date":"1999-08-01T00:00:00","date_gmt":"1999-08-01T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/age-and-gender-related-use-of-low-dose-drug-therapy-the-need-to-manufacture-low-dose-therapy-and-evaluate-the-minimum-effective-dose\/"},"modified":"2023-06-14T20:07:43","modified_gmt":"2023-06-15T00:07:43","slug":"age-and-gender-related-use-of-low-dose-drug-therapy-the-need-to-manufacture-low-dose-therapy-and-evaluate-the-minimum-effective-dose","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/age-and-gender-related-use-of-low-dose-drug-therapy-the-need-to-manufacture-low-dose-therapy-and-evaluate-the-minimum-effective-dose\/","title":{"rendered":"Age- and gender-related use of low-dose drug therapy: the need to manufacture low-dose therapy and evaluate the minimum effective dose"},"content":{"rendered":"<p><strong>Objectives<\/strong> &#x2014; Low-dose drug therapy is promoted as a way to maximize benefit and minimize adverse drug effects when prescribing for older adults. This population-based study evaluates the age and sex-related use of two common therapies: thiazide diuretics, where evidence supports the use of low-dose therapy, and beta-blockers, where trials have not evaluated the minimum effective dose.<\/p>\n<p><strong>Design<\/strong> &#x2014; Using linked administrative databases we identified all of the 120,613 persons dispensed a thiazide diuretic therapy and 12,908 myocardial infarction survivors dispensed beta-blocker therapy in Canada&apos;s largest province. We used logistic regression models to study the association of age and sex with dispensing of low-dose thiazide diuretic and beta-blocker therapy at doses lower than evaluated in trials.<\/p>\n<p><strong>Results<\/strong> &#x2014; Of 120,613 older people dispensed a thiazide diuretic, 32,372 (26.8%) were dispensed a low dose. Patients 85 years of age or older, relative to the youngest group, were 30% more likely to be dispensed low-dose therapy (OR=1.31; 95% CI, 1.27 to 1.36; P &lt; .001). Women were 8% more likely than men to be dispensed a low-dose thiazide diuretic (OR=1.08; 95% CI, 1.05 to 1.11; P &lt; .001). Of 10,991 myocardial infarction survivors dispensed atenolol, metoprolol, propranolol, or timolol, 9458 (86.1%) were dispensed a lower-than-evaluated dose. Patients 85 years of age or older, relative to those in the youngest group, were more than twice as likely to be dispensed a lower-than-evaluated beta-blocker therapy dose (OR=2.28; 95% CI, 1.74 to 3.04; P &lt; .001). No difference was noted in the use of beta-blocker therapy dose by sex (OR=1.0; 95% CI, .89 to 1.15; P = .95).<\/p>\n<p><strong>Conclusions<\/strong> &#x2014; Low-dose thiazide diuretic therapy prescribed widely to older people, particularly those of advanced age and women. The vast majority of myocardial infarction survivors were dispensed beta-blocker therapy at lower-than-evaluated doses. These findings highlight the need to manufacture low-dose thiazide diuretic therapy and to evaluate the minimum effective dose of beta-blocker therapy.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Objectives &#x2014; Low-dose drug therapy is promoted as a way to maximize benefit and minimize adverse drug effects when prescribing for older adults. This population-based study evaluates the age and sex-related use of two common therapies: thiazide diuretics, where evidence supports the use of low-dose therapy, and beta-blockers, where trials have not evaluated the minimum [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[56],"migration-helper-qa-sample-set":[],"class_list":["post-6375","journal_article","type-journal_article","status-publish","hentry","topic-pharmacoepidemiology-and-drug-safety"],"acf":{"citation":"Rochon PA, Anderson GM, Tu JV, Gurwitz JH, Clark JP, Shear NH, Lau P. <em>J Am Geriatr Soc<\/em>. 1999; 47(8):954-9.","source_url":"","ices_scientist":[1340,1382],"site":[6735,6733],"research_program":[6742,6746,6740],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"DB52D196-514D-4932-BD32-E0ADE2264045","sitecore_item_name":"Age-and-gender-related-use-of-low-dose-drug-therapy-the-need-to-manufacture-low-dose-therapy","sitecore_field_values":"{\n  \"Title\": \"Age- and gender-related use of low-dose drug therapy: the need to manufacture low-dose therapy and evaluate the minimum effective dose\",\n  \"Short title\": \"Age- and gender-related use of low-dose\",\n  \"Citation\": \"<p>Rochon PA, Anderson GM, Tu JV, Gurwitz JH, Clark JP, Shear NH, Lau P. <em>J Am Geriatr Soc<\/em>. 1999; 47(8):954-9.<\/p>\",\n  \"Abstract\": \"<p><strong>Objectives<\/strong> &mdash; Low-dose drug therapy is promoted as a way to maximize benefit and minimize adverse drug effects when prescribing for older adults. This population-based study evaluates the age and sex-related use of two common therapies: thiazide diuretics, where evidence supports the use of low-dose therapy, and beta-blockers, where trials have not evaluated the minimum effective dose.<\/p>rn<p><strong>Design<\/strong> &mdash; Using linked administrative databases we identified all of the 120,613 persons dispensed a thiazide diuretic therapy and 12,908 myocardial infarction survivors dispensed beta-blocker therapy in Canada's largest province. We used logistic regression models to study the association of age and sex with dispensing of low-dose thiazide diuretic and beta-blocker therapy at doses lower than evaluated in trials.<\/p>rn<p><strong>Results<\/strong> &mdash; Of 120,613 older people dispensed a thiazide diuretic, 32,372 (26.8%) were dispensed a low dose. Patients 85 years of age or older, relative to the youngest group, were 30% more likely to be dispensed low-dose therapy (OR=1.31; 95% CI, 1.27 to 1.36; P &lt; .001). Women were 8% more likely than men to be dispensed a low-dose thiazide diuretic (OR=1.08; 95% CI, 1.05 to 1.11; P &lt; .001). Of 10,991 myocardial infarction survivors dispensed atenolol, metoprolol, propranolol, or timolol, 9458 (86.1%) were dispensed a lower-than-evaluated dose. Patients 85 years of age or older, relative to those in the youngest group, were more than twice as likely to be dispensed a lower-than-evaluated beta-blocker therapy dose (OR=2.28; 95% CI, 1.74 to 3.04; P &lt; .001). No difference was noted in the use of beta-blocker therapy dose by sex (OR=1.0; 95% CI, .89 to 1.15; P = .95).<\/p>rn<p><strong>Conclusions<\/strong> &mdash; Low-dose thiazide diuretic therapy prescribed widely to older people, particularly those of advanced age and women. The vast majority of myocardial infarction survivors were dispensed beta-blocker therapy at lower-than-evaluated doses. These findings highlight the need to manufacture low-dose thiazide diuretic therapy and to evaluate the minimum effective dose of beta-blocker therapy.<\/p>\",\n  \"Keywords\": \"{B711DE54-5056-420D-AA0E-1349F1D88049}\",\n  \"Research Programs\": \"{BEC72DE0-BA8C-42B8-ACE5-EE29FFB2CB3B}|{CFE36C89-C969-4C23-B5E4-1BA9E5BDC273}|{46DF28D2-EDE8-4DF2-8CC0-87CEF464E435}\",\n  \"ICES Locations\": \"{FBE2D1B1-C0BA-423F-8D16-39466B6C1424}|{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{14B76C34-3A35-4785-86C4-9B1633E28765}|{38899D1B-38E7-4517-8DA3-0BDDF1F9944D}|{956599EC-5699-41D3-9375-E0B6C25B12D5}\",\n  \"Posted Date\": \"19990801T000000\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/1999\/January\/Age-and-gender-related-use-of-low-dose-drug-therapy-the-need-to-manufacture-low-dose-therapy"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Age- and gender-related use of low-dose drug therapy: the need to manufacture low-dose therapy and evaluate the minimum effective dose<\/title>\n<meta name=\"description\" content=\"Objectives &#x2014; 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