Long-term trends in antithrombotic drug prescriptions among adults age 80 years and over from primary care. A temporal trends analysis using electronic health records

Purpose This study aimed to estimate trends in antithrombotic prescriptions from 2001 to 2015 among people aged 80 years and over within clinical indications. Methods A prospective cohort study with 215,559 participants registered with the UK Clinical Practice Research Datalink (CPRD) from 2001 to 2015 were included in the analyses. The prevalence and incidence of antiplatelet and anticoagulant drugs were estimated for each year, and by five clinical indications. Results The prevalence rate of antithrombotic prescriptions among patients over 80 years of age and diagnosed with atrial fibrillation increased from 53% in 2001 to 77% in 2015 (Ptrend <0.001). Anticoagulant prescriptions rates also increased five-fold in older adults with atrial fibrillation from around 10% in 2001 to 46% in 2015 (Ptrend<0.001). Clopidogrel prescribing rates in patients over 80 years of age and with venous thrombosis increased from 0.4% in 2001 to 10% in 2015 (Ptrend<0.001). Warfarin prescribing in older patients with venous thrombosis increased from 13% in 2001 to 21% in 2015 (Ptrend<0.001). Conclusion The use of antithrombotic drugs increased from 2001 to 2015 in people age 80 years and over across multiple clinical indications. Assessing the benefits and harms of antithrombotic drugs across different clinical indications in older people is a priority.