Dataset Information

Patient Characteristics and General Practitioners' Advice to Stop Statins in Oldest-Old Patients: a Survey Study Across 30 Countries.

ABSTRACT:

Background

Statins are widely used to prevent cardiovascular disease (CVD). With advancing age, the risks of statins might outweigh the potential benefits. It is unclear which factors influence general practitioners' (GPs) advice to stop statins in oldest-old patients.

Objective

To investigate the influence of a history of CVD, statin-related side effects, frailty and short life expectancy, on GPs' advice to stop statins in oldest-old patients.

Design

We invited GPs to participate in this case-based survey. GPs were presented with 8 case vignettes describing patients > 80 years using a statin, and asked whether they would advise stopping statin treatment.

Main measures

Cases varied in history of CVD, statin-related side effects and frailty, with and without shortened life expectancy (< 1 year) in the context of metastatic, non-curable cancer. Odds ratios adjusted for GP characteristics (OR_adj) were calculated for GPs' advice to stop.

Key results

Two thousand two hundred fifty GPs from 30 countries participated (median response rate 36%). Overall, GPs advised stopping statin treatment in 46% (95%CI 45-47) of the case vignettes; with shortened life expectancy, this proportion increased to 90% (95CI% 89-90). Advice to stop was more frequent in case vignettes without CVD compared to those with CVD (OR_adj 13.8, 95%CI 12.6-15.1), with side effects compared to without OR_adj 1.62 (95%CI 1.5-1.7) and with frailty (OR_adj 4.1, 95%CI 3.8-4.4) compared to without. Shortened life expectancy increased advice to stop (OR_adj 50.7, 95%CI 45.5-56.4) and was the strongest predictor for GP advice to stop, ranging across countries from 30% (95%CI 19-42) to 98% (95% CI 96-99).

Conclusions

The absence of CVD, the presence of statin-related side effects, and frailty were all independently associated with GPs' advice to stop statins in patients aged > 80 years. Overall, and within all countries, cancer-related short life expectancy was the strongest independent predictor of GPs' advice to stop statins.

SUBMITTER: van der Ploeg MA

PROVIDER: S-EPMC6711940 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Patient Characteristics and General Practitioners' Advice to Stop Statins in Oldest-Old Patients: a Survey Study Across 30 Countries.

van der Ploeg Milly A MA Streit Sven S Achterberg Wilco P WP Beers Erna E Bohnen Arthur M AM Burman Robert A RA Collins Claire C Franco Fabio G FG Gerasimovska-Kitanovska Biljana B Gintere Sandra S Gomez Bravo Raquel R Hoffmann Kathryn K Iftode Claudia C Peštić Sanda Kreitmayer SK Koskela Tuomas H TH Kurpas Donata D Maisonneuve Hubert H Mallen Christan D CD Merlo Christoph C Mueller Yolanda Y Muth Christiane C Petrazzuoli Ferdinando F Rodondi Nicolas N Rosemann Thomas T Sattler Martin M Schermer Tjard T Šter Marija Petek MP Švadlenková Zuzana Z Tatsioni Athina A Thulesius Hans H Tkachenko Victoria V Torzsa Péter P Tsopra Rosy R Tuz Canan C Vaes Bert B Viegas Rita P A RPA Vinker Shlomo S Wallis Katharine A KA Zeller Andreas A Gussekloo Jacobijn J Poortvliet Rosalinde K E RKE

Journal of general internal medicine 20190116 9

<h4>Background</h4>Statins are widely used to prevent cardiovascular disease (CVD). With advancing age, the risks of statins might outweigh the potential benefits. It is unclear which factors influence general practitioners' (GPs) advice to stop statins in oldest-old patients.<h4>Objective</h4>To investigate the influence of a history of CVD, statin-related side effects, frailty and short life expectancy, on GPs' advice to stop statins in oldest-old patients.<h4>Design</h4>We invited GPs to part ...[more]

PMID: 30652277

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Dataset Information

Patient Characteristics and General Practitioners' Advice to Stop Statins in Oldest-Old Patients: a Survey Study Across 30 Countries.

Background

Objective

Design

Main measures

Key results

Conclusions

Publications

Patient Characteristics and General Practitioners' Advice to Stop Statins in Oldest-Old Patients: a Survey Study Across 30 Countries.

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