A secondary analysis of OECD Patient-Reported Indicator Surveys, discussed on the TTHealthWatch podcast, examined how primary care experiences vary for adults 45 and older with chronic conditions. Across 19 countries and about 70,000 respondents, better experiences were tied to having a usual provider and a care coordinator in the practice. The most common conditions were hypertension, arthritis, cardiovascular disease, and diabetes.
The same podcast covered a New England Journal of Medicine trial randomizing nearly 10,000 70-year-olds without cardiovascular disease, diabetes, or dementia to atorvastatin or placebo. After about six years, statins reduced cardiovascular death, heart attacks, and strokes by 20–30% and lowered cholesterol by about 35%. However, there was no improvement in disability-free survival—meaning no difference in living longer, avoiding dementia, or preventing physical disability.
The hosts concluded that primary care continuity and coordination can be delivered at scale, while statin use in older adults without prior cardiovascular disease is a shared decision. The drugs improve cardiovascular outcomes but do not appear to improve overall outcomes in this population.