Frailty and prescriptions of secondary prevention medications in older people with diabetes and coronary heart disease—An observational study in Vietnam

Objectives

This study sought to quantify the prevalence of frailty among type 2 diabetes (T2D) patients with coronary heart disease (CHD) and examine the relationship between frailty and the prescription of secondary prevention medications.

Methods

A prospective observational study was conducted at a tertiary hospital in Vietnam from November 2022 to June 2023. Patients aged 60 years or above with T2D and CHD were included for analysis. Multivariable logistic regression was applied to examine the association between frailty and the prescription of secondary prevention medications: antiplatelets, statins, beta-blockers, angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (ACEIs/ARBs). Frailty was measured using the Clinical Frailty Scale (CFS) version 2.0.

Results

There were 274 participants included in this analysis. Participants had a median age of 72.0 years, 28% were female and 59% were frail. The prescription rates of cardiovascular medicines for frail versus non-frail participants were as follows: antiplatelets (66% vs. 94%, p < .001), statins (96% vs. 92%, p = .21), beta-blockers (81% vs. 88%, p = .13), ACEIs/ARBs (75% vs. 81%, p = .22) and for all four types (42% vs. 64%, p < .001). In the multiple adjusted regression models, increased CFS score was associated with reduced prescriptions of beta-blockers, ACEIs/ARBs and all four types of medications.

Conclusions

Frailty was common among older Vietnamese patients with CHD and diabetes, and significantly affected the prescription of secondary prevention medicines. Future research should explore the link between frailty and secondary prevention medicines in a larger, more diverse population.