Evidence map›Paper›PMID 31663610›Full record

SynthesisJournal of the American Geriatrics Society2020

Recommendations for (Discontinuation of) Statin Treatment in Older Adults: Review of Guidelines.

Milly A van der Ploeg, Carmen Floriani, Wilco P Achterberg, Jonathan M K Bogaerts, Jacobijn Gussekloo, Simon P Mooijaart, Sven Streit, Rosalinde K E Poortvliet, Yvonne M Drewes

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of the American Geriatrics Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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  5. Trial
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  17. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Milly A van der PloegDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
Carmen FlorianiInstitute of Primary Health Care (Berner Institut für Hausarztmedizin, BIHAM), University of Bern, Bern, Switzerland.
Wilco P AchterbergDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
Jonathan M K BogaertsDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
Jacobijn GusseklooDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
Simon P MooijaartDepartment of Internal Medicine, Section Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.ORCID 0000-0003-3106-3568
Sven StreitInstitute of Primary Health Care (Berner Institut für Hausarztmedizin, BIHAM), University of Bern, Bern, Switzerland.ORCID 0000-0002-3813-4616
Rosalinde K E PoortvlietDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
Yvonne M DrewesDepartment of Internal Medicine, Section Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesAs a person's age increases and his/her health status declines, new challenges arise that may lead physicians to consider deprescribing statins. We aimed to provide insight into recommendations available in international cardiovascular disease prevention guidelines regarding discontinuation of statin treatment applicable to older adults.

designWe systematically searched PubMed, EMBASE, EMCARE, and the websites of guideline development organizations and online guideline repositories for cardiovascular disease prevention guidelines aimed at the general population. We selected all guidelines with recommendations (instructions and suggestions) on discontinuation of statin treatment applicable to older adults, published between January 2009 and April 2019. In addition, we performed a synthesis of information from all other recommendations for older adults regarding statin treatment. Methodological quality of the included guidelines was appraised using the appraisal of guidelines for research & evaluation II (AGREE II) instrument.

resultsEighteen international guidelines for cardiovascular disease prevention in the general adult population provided recommendations for statin discontinuation that were applicable to older adults. We identified three groups of instructions for statin discontinuation related to statin intolerance, and none was specifically aimed at older adults. Three guidelines also included suggestions to consider statin discontinuation in patients with poor health status. Of the 18 guidelines included, 16 made recommendations regarding statin treatment in older adults, although details on how to implement these recommendations in practice were not provided.

conclusionCurrent international cardiovascular disease prevention guidelines provide little specific guidance for physicians who are considering statin discontinuation in older adults in the context of declining health status and short life expectancy. J Am Geriatr Soc 68:417-425, 2020.

Indexed as

Practice Guidelines as TopicAgedAged, 80 and overAge FactorsCardiovascular DiseasesFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleWithholding TreatmentHydroxymethylglutaryl-CoA Reductase Inhibitorscardiovascular diseasesclinical decision makingdrug therapyhydroxymethylglutaryl-CoA reductase inhibitorsprevention

Identifiers

PMID31663610
PMCPMC7027549

What Socratic holds

Texttitle and abstract
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.