{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T22:26:14Z","timestamp":1762899974059,"version":"3.40.5"},"reference-count":19,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,7,27]],"date-time":"2020-07-27T00:00:00Z","timestamp":1595808000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>The benefits of antiplatelets to prevent cardio\u2010 and cerebrovascular disease are recognized and appropriate only for \u201csecondary prevention.\u201d This multicenter retrospective study was designed to (i) examine the prevalence of residents receiving antiplatelets for primary and secondary cardio\u2010 and cerebrovascular prevention, and (ii) evaluate the predictors of inappropriate antiplatelet prescription.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was conducted in a sample of Italian long\u2010term care nursing homes (NHs). Appropriate use of antiplatelets was defined in accordance with the strongest evidence\u2010based indications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 2579 patients recruited from 27 long\u2010term care NHs (age mean\u2009\u00b1\u2009SD: 86.8\u2009\u00b1\u20097.3; women: 1995; 77.4%), 1092 were treated with antiplatelets (42.3%) and 619 (56.7%) were receiving antiplatelet agents for inappropriate primary prevention of cardio\u2010 or cerebrovascular atherothrombotic events. Age, dementia or cerebral atherosclerosis, congestive heart failure, peripheral vascular disease, diabetes without chronic complication and hypertension were predictors of inappropriate prescription of antiplatelets. Patients inappropriately treated with antiplatelets also had a higher risk of receiving proton pump inhibitors than those appropriately not treated in univariate (OR 95% CI = 2.79 (2.25\u20133.46, <jats:italic>p<\/jats:italic> &lt; 0.0001) and multivariate models (OR 95% CI 2.71 (2.16\u20133.40, <jats:italic>p<\/jats:italic> &lt; 0.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Most patients receiving antiplatelet agents in NHs are being inappropriately treated for primary prevention of cardio\u2010 or cerebrovascular disease. NH residents with diagnosis of dementia or cerebral atherosclerosis, congestive heart failure, peripheral vascular disease, diabetes without chronic complication and hypertension seemed more likely to receive antiplatelets inappropriately. Patients without an evidence\u2010based indication for antiplatelets also received proton\u2010pump inhibitors in an unnecessary \u201cprescribing cascade,\u201d which should be assessed for de\u2010prescribing. <jats:bold>Geriatr Gerontol Int 2020; 20: 828\u2013832<\/jats:bold>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ggi.13984","type":"journal-article","created":{"date-parts":[[2020,7,27]],"date-time":"2020-07-27T17:04:03Z","timestamp":1595869443000},"page":"828-832","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Inappropriate use of antiplatelet agents for primary prevention in nursing homes: An Italian multicenter observational study"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4777-1350","authenticated-orcid":false,"given":"Luca","family":"Pasina","sequence":"first","affiliation":[{"name":"Istituto di Ricerche Farmacologiche Mario Negri IRCCS  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessio","family":"Novella","sequence":"additional","affiliation":[{"name":"Istituto di Ricerche Farmacologiche Mario Negri IRCCS  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Elli","sequence":"additional","affiliation":[{"name":"Istituto di Ricerche Farmacologiche Mario Negri IRCCS  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Nobili","sequence":"additional","affiliation":[{"name":"Istituto di Ricerche Farmacologiche Mario Negri IRCCS  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aladar","family":"Ianes","sequence":"additional","affiliation":[{"name":"Medical Direction, Korian Italy  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,7,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-123-3-199508010-00007"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjopharm.2010.01.001"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/02813432.2016.1207142"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-016-2193-z"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.4142"},{"key":"e_1_2_8_7_1","first-page":"8","article-title":"Drugs prescribed for elderly patients in nursing homes or under medical home care","volume":"3","author":"Andersson M","year":"1989","journal-title":"Compr Gerontol A"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s002280050012"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/26.5.383"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-020-02871-7"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60503-1"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.191037"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15767"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1998.tb01079.x"},{"key":"e_1_2_8_15_1","first-page":"320","article-title":"Cross\u2010national comparison of medication use in Australian and Dutch nursing homes","volume":"46","author":"Taxis K","year":"2017","journal-title":"Age Ageing"},{"key":"e_1_2_8_16_1","first-page":"CD001296","article-title":"Spector A for vascular dementia","volume":"4","author":"Williams PS","year":"2000","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_17_1","first-page":"CD006378","article-title":"Steroidal and non\u2010steroidal anti\u2010inflammatory drugs for the treatment of Alzheimer's disease","volume":"2","author":"Jaturapatporn D","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMe1812000"},{"key":"e_1_2_8_19_1","unstructured":"http:\/\/www.thennt.com\/nnt\/-to-prevent-a-first-heart-attack-or-stroke-2\/"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.0324"}],"container-title":["Geriatrics &amp; 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