(027) Publicly funded prescription drugs dispensed to community dwelling New Brunswick older adults following hospital discharge for myocardial infarction between 2009 and 2017
Background: The Canadian guidelines for effective therapies in secondary prevention after myocardial infarction (MI) were revised in 2010, recommending the use of potent antiplatelet medication, P2Y12 inhibitors. However, no studies using administrative health claims data from any Canadian province have been published to assess the use of P2Y12 inhibitors post-MI. Additionally, there is a lack of published data from the province of New Brunswick (NB) regarding the proportion of MI survivors who receive any of the recommended medications.
Objectives: The objective was to estimate the annual proportion of elderly survivors of MI who were dispensed guideline-directed medications after hospital discharge in NB.
Methods: A serial cross-sectional study was conducted using linked administrative health databases curated by the NB Institute for Health Research, Data, and Training. Subjects included community-dwelling individuals aged 66 years and older with publicly covered drug insurance who were discharged home from hospital after an MI between January 2009 and December 2017. The outcome was the annual proportion of patients who filled a prescription for a statin, β-blocker, renin-angiotensin-aldosterone system inhibitors (RAAS; using angiotensin-converting enzyme inhibitors or angiotensin receptor blockers), and P2Y12-inhibitor, within 90-days of hospital discharge. A chi-squared test of independence was used to analyze the trend over time.
Results: The cohort consisted of 2674 subjects, 53% of whom were men, with a mean age of 78 y [standard deviation (SD) 8]. Overall, 79% of subjects received a β-blocker, 71% received a RAAS agent, 83% received a statin, and 70% received a P2Y12 inhibitor within 90 days of hospital discharge. There were no statistically significant trends in the annual proportion of subjects dispensed each medication class over time.
Conclusions: The proportion of patients receiving medications post-discharge remained constant between 2009 and 2017 in NB. These results are comparable to estimates from other Canadian provinces.
