TY - JOUR
T1 - Perceptions of Statin Discontinuation among Patients with Life-Limiting Illness
AU - Tjia, Jennifer
AU - Kutner, Jean S.
AU - Ritchie, Christine S.
AU - Blatchford, Patrick J.
AU - Bennett Kendrick, Rachael E.
AU - Prince-Paul, Maryjo
AU - Somers, Tamara J.
AU - McPherson, Mary Lynn
AU - Sloan, Jeff A.
AU - Abernethy, Amy P.
AU - Furuno, Jon P.
N1 - Funding Information:
This project was supported by the Palliative Care Research Cooperative Group funded by the National Institute of Nursing Research award number UC4NR12584 and U24NR014637. The authors would like to thank the participants and investigators of the Statin Discontinuation in Advanced Illness clinical trial.
Publisher Copyright:
© Copyright 2017, Mary Ann Liebert, Inc. 2017.
PY - 2017/10
Y1 - 2017/10
N2 - Background: Optimal management of chronic medications for patients with life-limiting illness is uncertain. Medication deprescribing may improve outcomes in this population, but patient concerns regarding deprescribing are unclear. Objective: The aim of this study was to quantify the perceived benefits and concerns of statin discontinuation among patients with life-limiting illness. Design: Baseline data from a multicenter, pragmatic clinical trial of statin discontinuation were used. Setting/Subjects: Cognitively intact participants with a life expectancy of 1-12 months receiving statin medications for primary or secondary prevention were enrolled. Measurements: Responses to a 9-item questionnaire addressing patient concerns about discontinuing statins were collected. We used Pearson chi-square tests to compare responses by primary life-limiting diagnosis (cancer, cardiovascular disease, other). Results: Of 297 eligible participants, 58% had cancer, 8% had cardiovascular disease, and 30% other primary diagnoses. Mean (standard deviation) age was 72 (11) years. Fewer than 5% of participants expressed concern that statin deprescribing indicated physician abandonment. About one in five participants reported being told to take statins for the rest of their life (18%) or feeling that discontinuation represented prior wasted effort (18%). Many participants reported benefits of stopping statins, including spending less money on medications (63%), potentially stopping other medications (34%), and having a better quality of life (25%). More participants with cardiovascular disease as a primary diagnosis perceived that quality-of-life benefits related to statin discontinuation (52%) than participants with cancer (27%) or noncardiovascular disease diagnoses (27%) [p = 0.034]. Conclusion: Few participants expressed concerns about discontinuing statins; many perceived potential benefits. Cardiovascular disease patients perceived greater potential positive impact from statin discontinuation.
AB - Background: Optimal management of chronic medications for patients with life-limiting illness is uncertain. Medication deprescribing may improve outcomes in this population, but patient concerns regarding deprescribing are unclear. Objective: The aim of this study was to quantify the perceived benefits and concerns of statin discontinuation among patients with life-limiting illness. Design: Baseline data from a multicenter, pragmatic clinical trial of statin discontinuation were used. Setting/Subjects: Cognitively intact participants with a life expectancy of 1-12 months receiving statin medications for primary or secondary prevention were enrolled. Measurements: Responses to a 9-item questionnaire addressing patient concerns about discontinuing statins were collected. We used Pearson chi-square tests to compare responses by primary life-limiting diagnosis (cancer, cardiovascular disease, other). Results: Of 297 eligible participants, 58% had cancer, 8% had cardiovascular disease, and 30% other primary diagnoses. Mean (standard deviation) age was 72 (11) years. Fewer than 5% of participants expressed concern that statin deprescribing indicated physician abandonment. About one in five participants reported being told to take statins for the rest of their life (18%) or feeling that discontinuation represented prior wasted effort (18%). Many participants reported benefits of stopping statins, including spending less money on medications (63%), potentially stopping other medications (34%), and having a better quality of life (25%). More participants with cardiovascular disease as a primary diagnosis perceived that quality-of-life benefits related to statin discontinuation (52%) than participants with cancer (27%) or noncardiovascular disease diagnoses (27%) [p = 0.034]. Conclusion: Few participants expressed concerns about discontinuing statins; many perceived potential benefits. Cardiovascular disease patients perceived greater potential positive impact from statin discontinuation.
KW - deprescribing
KW - medication discontinuation
KW - statins
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U2 - 10.1089/jpm.2016.0489
DO - 10.1089/jpm.2016.0489
M3 - Article
C2 - 28520522
AN - SCOPUS:85030218630
SN - 1096-6218
VL - 20
SP - 1098
EP - 1103
JO - Journal of Palliative Medicine
JF - Journal of Palliative Medicine
IS - 10
ER -