Influence of patient characteristics on GPs advice on stopping statins in oldest-old: survey study across GPs from 30 countries

A. Howe, A. Murphy, Ross Murtagh, D. Swan, Eileen O'Connor, G. McCombe, C. Murphy, J. Lambert, Gordana Avramovic, W. Cullen, E. Hummers-Pradier, Michaela Aschenbrenner, Ildikó Gágyor, Jutta Bleidorn, S. Heim, Guido Schmiemann, C. Collins, James Larkin, Ivana Pericin, B. OsborneP. Dodd, A. Jennings, T. Foley, S. McHugh, J. Browne, C. Bradley, Miroslav Hanževački, Sven Streit, Rosalinde Poortvliet, Jacobijn Gussekloo, P. Nabbe, J. oDoherty, Jennifer Gettings, Robyn M. oConnor, A. Hannigan, L. Hickey, A. ORegan, Yochai Schonmann, Or Goren, Ronen Bareket, Doron Comaneshter, A. Cohen, Shlomo Vinker, L. Pas, Trudy Bekkering, Evelien Lenaerts, C. Mathei, B. Aertgeerts, J. S. Cadwallader, Massimiliano Orri, C. Hassler, C. Barry, B. Falissard, Caroline Huas, Anja Cerne, Davorina Petek, P. Selič, Ailis Ni Riain, T. O'Sullivan, Gerard Mansfield, O. Gonzalez, Aine Waters, James Keogh, Nora Kavanagh, Clare ONeill, G. McGuire, M. Kelly, Anna Berenguera, Enriqueta Pujol-Ribera, Victòria Carmona-Terés, Mariona Pons-Vigués, Joana Moix-Queraltó, Anna Neary, E. Beary, E. McCarron, Leanne Hanrahan, O. Murphy, P. Ruane, Bibiana Savin, B. O'Shea, A. Ní Shúilleabháin, Aelita Skarbalieo, Teresa Pawlikovska, Eva Lena Strandberg, A. Jurgutis, Cedric Rat, Aurelie Gaultier, J. Nguyen, C. Berkhout, Amy Willefert-Bouche, E. Chazard, Suzanna Zgorska-Maynard Moussa, Favre Jonathan, L. Peremans, Gregoire Ficheur, P. Van Royen, Milly Anna Altena-Van Der Ploeg, Nettie Blankenstein, E. Beers, Arthur Bohnen, D. Bonfim, Huib Burger, R. Burman, Tuz Canan, F. G. de Mello Franco, M. D. de Waal, Biljana Gerasimovska-Kitanovska, Sandra Gintere, R. Bravo, K. Hoffmann, Claudia Iftode, Kasper Johansen, T. Koskela, D. Kurpas, H. Maisonneuve, C. Mallen, Christoph Merlo, Y. Mueller, C. Muth, Martin Sattler, Sanda K Peštić, Ferdinando Petrazzuoli, N. Rodondi, T. Rosemann, T. Schermer, Marija Petek Šter, Z. Švadlenková, Athina Tatsioni, H. Thulesius, Victoria Tkachenko, P. Torzsa, Rosy Tsopra, B. Vaes, M. van den Akker, R. Viegas, K. Wallis, A. Zeller, Heloise Schmeltz, S. Rocher, M. Beyer, L. Uhlmann, C. Guethlin, M. Hammer, F. Gerlach, Karimova Kateryna

Research output: Contribution to journalMeeting Abstractpeer-review

Abstract

Background: Statins are widely used to prevent cardiovascular disease (CVD). Current guidelines give little advice on when to stop statin treatment. GPs must rely on other factors like patient characteristics or common practice when making treatment decisions. Research questions: Do patient-related characteristics (frailty, statin-related side effects, history of CVD or limited life expectancy) influence GPs’ advice to stop statins in the oldest old (>80 years)? Does advice vary across countries? Methods: GPs from 30 countries (27 in Europe, Brazil, Israel, and New Zealand) participated in a survey based on case vignettes. We compared treatment advice in cases of >80 years varying in frailty, statin-related side effects, history of CVD and life expectancy <1 year. We compared the percentage of cases per GP that would be advised to stop. We used mixed-effect models to calculate odd ratio’s (ORsadj) adjusted for GP characteristics (such as gender) as fixed effects; country and GPs were adjusted as random effects. Results: n = 2250. When no information about life expectancy was given, GPs advised stopping statin treatment in 46% of the cases (range: 23–58% across countries). When ‘life expectancy <1 year’ was added to case descriptions, GPs advised stopping statins in an additional 82% of the cases (range: 30–98% across countries). Frailty, side effects and life expectancy were associated with increased advice to stop (ORadj: 4.1; 95%CI: 3.8–4.4; ORadj: 1.62; 95%CI: 1.5–1.7 ORadj: 50.7; 95%CI: 45.5–56.4, respectively), while history of CVD was strongly related with decreased advice to stop (ORadj: 0.07; 95%CI: 0.07–0.08). Conclusion: GPs were more likely to advise stopping statin treatment in >80 year-old patients when patients were frail, suffering statin side effects or had limited life expectancy; and more likely to continue statin treatment as secondary prevention for CVD. There were considerable treatment variations across countries.
Original languageEnglish
Pages (from-to)211 - 222
JournalThe European Journal of General Practice
Volume24
Issue number1
Publication statusPublished - 2018

Fingerprint

Dive into the research topics of 'Influence of patient characteristics on GPs advice on stopping statins in oldest-old: survey study across GPs from 30 countries'. Together they form a unique fingerprint.

Cite this