ArticleJournal of the American Geriatrics Society2020
Discontinuation of Statins in Veterans Admitted to Nursing Homes near the End of Life.
Article 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 14 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Deprescribing in cardiometabolic conditions in older patients: a systematic review.GeroScience · 2023Pooled it
- Real-world patterns of cardiovascular medication use in the final 28 days of life among patients with advanced cancer: a retrospective analysis by hospice care type.BMC palliative care · 2025Article
- The impact of palliative care consults on medicines optimisation for patients with cancer referred to hospice care at the end of life: a retrospective cohort study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Defining key deprescribing measures from electronic health data: A multisite data harmonization project.Journal of the American Geriatrics Society · 2025Article
- Validating claims-based definitions for deprescribing: Bridging the gap between clinical and administrative data.Pharmacoepidemiology and drug safety · 2024Article
- Clinician and Family Caregiver Perspectives on Deprescribing Chronic Disease Medications in Older Nursing Home Residents Near the End of Life.Drugs & aging · 2024Article
- Prescriber Perspectives and Experiences with Deprescribing Versus Continuing Bisphosphonates in Older Nursing Home Residents with Dementia.Journal of general internal medicine · 2023Article
- Deprescribing research in nursing home residents using routinely collected healthcare data: a conceptual framework.BMC geriatrics · 2023Review
- Supporting deprescribing in long-term care: An approach using stakeholder engagement, behavioural science and implementation planning.Exploratory research in clinical and social pharmacy · 2022Article
- Effect of Deintensifying Diabetes Medications on Negative Events in Older Veteran Nursing Home Residents.Diabetes care · 2022Article
- Inverse Association between Statin Use and Cancer Mortality Relates to Cholesterol Level.Cancers · 2022Article
- Article
- Methodological Challenges for Epidemiologic Studies of Deprescribing at the End of Life.Current epidemiology reports · 2021Article
- Geographic Variation of Statin Use Among US Nursing Home Residents With Life-limiting Illness.Medical care · 2021Article
Corrections and comments
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Authors and funding
14 authors at 6 institutions in 1 country.
Funding
Abstract
BACKGROUND/
objectivesGeriatric guidelines recommend against statin use in older adults with limited life expectancy (LLE) or advanced dementia (AD). This study examined resident and facility factors predicting statin discontinuation after nursing home (NH) admission in veterans with LLE/AD taking statins for secondary prevention.
designRetrospective cohort study of Veterans Affairs (VA) bar code medication administration records, Minimum Data Set (MDS) assessments, and utilization records linked to Medicare claims.
settingVA NHs, known as community living centers (CLCs).
participantsVeterans aged 65 and older with coronary artery disease, stroke, or diabetes mellitus, type II, admitted in fiscal years 2009 to 2015, who met criteria for LLE/AD on their admission MDS and received statins in the week after admission (n = 13,110). MEASUREMENTS: Residents were followed until statin discontinuation (ie, gap in statin use ≥14 days), death, or censoring due to discharge, day 91 of the stay, or end of the study period. Competing risk models assessed cumulative incidence and predictors of discontinuation, stratified by whether the resident had their end-of-life (EOL) status designated or used hospice at admission.
resultsOverall cumulative incidence of statin discontinuation was 31% (95% confidence interval [CI] = 30%-32%) by day 91, and it was markedly higher in those with (52%; 95% CI = 50%-55%) vs without (25%; 95% CI = 24%-26%) EOL designation/hospice. In patients with EOL designation/hospice (n = 2,374), obesity, congestive heart failure, and admission from nonhospital settings predicted decreased likelihood of discontinuation; AD, dependency in activities of daily living, greater number of medications, and geographic region predicted increased likelihood of discontinuation. In patients without EOL designation/hospice (n = 10,736), older age and several specific markers of poor prognosis predicted greater discontinuation, whereas obesity/overweight predicted decreased discontinuation.
conclusionMost veterans with LLE/AD taking statins for secondary prevention do not discontinue statins following CLC admission. Designating residents as EOL status, hospice use, and individual clinical factors indicating poor prognosis may prompt deprescribing.
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