Older people under-treated after stroke
Mon April 20th, 2009
Older people who have had a stroke are often under-treated in primary care, it has been claimed.
This lack of treatment "cannot be justified", say Professor Rosalind Raine of University College London, UK, and colleagues on the website of the British Medical Journal.
The allegation follows similar claims levelled last week by an elderly care specialist about "ageism" afflicting stroke patients in secondary care.
The University College team looked into the effects of drug treatment and the extent to which it varies by sex, age, and socioeconomic circumstances. They used figures from England's health improvement network primary care database on 12,830 patients aged 50 or above.
Overall, just 25.6 per cent of men and 20.8 per cent of women received preventative drugs. This did not vary by socioeconomic circumstances or by sex. However, older patients were "substantially less likely to receive treatment".
Compared with 50-59 year olds, the chance of 80-89 year olds receiving treatment was 47 per cent lower. Older people were much less likely to receive lipid lowering drugs.
When secondary prevention was given, it was associated with a 50 per cent reduction in mortality - from 11.1 per cent to 5.7 per cent during the first year after stroke.
Professor Raine and colleagues write: "Among patients with established coronary heart disease, nearly 78 per cent of prevented or postponed deaths are attributable to medical or surgical intervention."
They add: "Socially disadvantaged patients were not less likely to receive treatment than their more affluent counterparts" but "of more concern is the finding of under-use of lipid lowering therapies among elderly people".
They conclude that this cannot be justified, as "the survival benefits associated with lipid lowering drugs have been shown across multiple subgroups, including elderly patients".
Tags: UK News | Brain & Neurology | Heart Health | Elderly Health
Printer friendly page