Optimising cardioprotective medications in older adults living with frailty (360G-Wellcome-316439_Z_24_Z)

At least 10% of hospital admissions for older adults are due to medication- related harms. Optimising medications for older adults, especially those with frailty, is a national priority. However, there is a lack of evidence to guide prescribing, particularly for cardioprotective medications. This is particularly true for people living with frailty, who are at an increased risk of cardiovascular events, and adverse effects from cardioprotective medications. This PhD project will use a multi-methods approach. Firstly, I will use anonymised primary care records to evaluate the risks and benefits of stopping statins across different grades of frailty. Results will report how statin discontinuation affects the risk of hospitalisation, death or cardiovascular disease, as well as the avoidance of common side effects of statins. Secondly, I will use an existing prospective cohort to how baseline frailty and mobility decline are influenced by cardioprotective medications. Mobility decline is poorly recorded in primary care records, but is an important outcome to older adults. Thirdly, I will use longitudinal qualitative research to gain an in-depth understanding of the lived experience of frail patients prescribed cardioprotective medications. In harnessing different methods, I aim to provide a more nuanced evidence-base for cardioprotective medication optimisation in this population.