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Patient Characteris...
Patient Characteristics and General Practitioners' Advice to Stop Statins in Oldest-Old Patients : a Survey Study Across 30 Countries
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- van der Ploeg, Milly A. (författare)
- Leiden Univ, Netherlands,Leiden University Medical Centre
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- Streit, Sven (författare)
- Univ Bern, Switzerland
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- Achterberg, Wilco P. (författare)
- Leiden Univ, Netherlands
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- Beers, Erna (författare)
- Univ Amsterdam, Netherlands
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- Bohnen, Arthur M. (författare)
- Erasmus MC, Netherlands
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- Burman, Robert A. (författare)
- Vennesla Primary Hlth Care Ctr, Norway
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- Collins, Claire (författare)
- Irish Coll Gen Practitioners, Ireland
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- Franco, Fabio G. (författare)
- Hosp Israelita Albert Einstein, Brazil
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- Gerasimovska-Kitanovska, Biljana (författare)
- Univ St Cyril & Metodius, Macedonia
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- Gintere, Sandra (författare)
- Riga Stradins Univ, Latvia
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- Bravo, Raquel Gomez (författare)
- Univ Luxembourg, Luxembourg
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- Hoffmann, Kathryn (författare)
- Med Univ Vienna, Austria
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- Iftode, Claudia (författare)
- Timis Soc Family Med, Romania
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- Pestic, Sanda Kreitmayer (författare)
- Univ Tuzla, Bosnia and Herzegovina
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- Koskela, Tuomas H. (författare)
- Univ Tampere, Finland
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- Kurpas, Donata (författare)
- Wroclaw Med Univ, Poland
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- Maisonneuve, Hubert (författare)
- Univ Geneva, Switzerland
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- Mallen, Christan D. (författare)
- Keele Univ, UK
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- Merlo, Christoph (författare)
- Inst Primary & Community Care Lucerne IHAM, Switzerland
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- Mueller, Yolanda (författare)
- Inst Family Med Lausanne IUMF, Switzerland
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- Muth, Christiane (författare)
- Goethe Univ, Germany
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- Petrazzuoli, Ferdinando (författare)
- Lund University,Lunds universitet,Allmänmedicin och samhällsmedicin,Forskargrupper vid Lunds universitet,Family Medicine and Community Medicine,Lund University Research Groups,National Society of Medical Education in General Practice (SNAMID)
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- Rodondi, Nicolas (författare)
- Univ Bern, Switzerland
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- Rosemann, Thomas (författare)
- Univ Zurich, Switzerland
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- Sattler, Martin (författare)
- SSLMG, Luxembourg
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- Schermer, Tjard (författare)
- Radboud Univ Nijmegen, Netherlands
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- Ster, Marija Petek (författare)
- Univ Ljubljana, Slovenia
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- Svadlenkova, Zuzana (författare)
- Ordinace Repy Sro, Czech Republic
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- Tatsioni, Athina (författare)
- Univ Ioannina, Greece
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- Thulesius, Hans (författare)
- Lund University,Lunds universitet,Allmänmedicin och samhällsmedicin,Forskargrupper vid Lunds universitet,Family Medicine and Community Medicine,Lund University Research Groups,Region Kronoberg
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- Tkachenko, Victoria (författare)
- Shupyk Natl Med Acad Postgrad Educ, Ukraine
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- Torzsa, Peter (författare)
- Semmelweis Univ, Hungary
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- Tsopra, Rosy (författare)
- Univ Paris 13, France
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- Tuz, Canan (författare)
- Erzincan Univ, Turkey
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- Vaes, Bert (författare)
- Univ Leuven KU Leuven, Belgium
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- Viegas, Rita P. A. (författare)
- NOVA Med Sch, Portugal
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- Vinker, Shlomo (författare)
- Tel Aviv Univ, Israel
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- Wallis, Katharine A. (författare)
- Univ Auckland, New Zealand
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- Zeller, Andreas (författare)
- Univ Basel, Switzerland
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- Gussekloo, Jacobijn (författare)
- Leiden Univ, Netherlands
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- Poortvliet, Rosalinde K. E. (författare)
- Leiden Univ, Netherlands,Leiden University Medical Centre
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(creator_code:org_t)
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et al
- 2019-01-16
- 2019
- Engelska.
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Ingår i: Journal of general internal medicine. - : Springer. - 0884-8734 .- 1525-1497. ; 34:9, s. 1751-1757
- Relaterad länk:
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https://doi.org/10.1...
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https://link.springe...
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http://dx.doi.org/10... (free)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://lup.lub.lu.s...
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Abstract
Ämnesord
Stäng
- 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 (ORadj) 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 (ORadj 13.8, 95%CI 12.6-15.1), with side effects compared to without ORadj 1.62 (95%CI 1.5-1.7) and with frailty (ORadj 4.1, 95%CI 3.8-4.4) compared to without. Shortened life expectancy increased advice to stop (ORadj 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.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Geriatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Geriatrics (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Allmänmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- General Practice (hsv//eng)
Nyckelord
- hydroxymethylglutaryl-CoA reductase inhibitors
- cardiovascular diseases
- drug therapy
- palliative care
- general practitioners
- clinical decision-making
- Gerontology
- Gerontologi
- cardiovascular diseases
- clinical decision-making
- drug therapy
- general practitioners
- hydroxymethylglutaryl-CoA reductase inhibitors
- palliative care
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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van der Ploeg, M ...
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Streit, Sven
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Achterberg, Wilc ...
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Beers, Erna
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Bohnen, Arthur M ...
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Burman, Robert A ...
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visa fler...
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Collins, Claire
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Franco, Fabio G.
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Gerasimovska-Kit ...
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Gintere, Sandra
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Bravo, Raquel Go ...
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Hoffmann, Kathry ...
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Iftode, Claudia
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Pestic, Sanda Kr ...
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Koskela, Tuomas ...
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Kurpas, Donata
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Maisonneuve, Hub ...
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Mallen, Christan ...
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Merlo, Christoph
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Mueller, Yolanda
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Muth, Christiane
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Petrazzuoli, Fer ...
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Rodondi, Nicolas
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Rosemann, Thomas
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Sattler, Martin
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Schermer, Tjard
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Ster, Marija Pet ...
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Svadlenkova, Zuz ...
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Tatsioni, Athina
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Thulesius, Hans
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Tkachenko, Victo ...
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Torzsa, Peter
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Tsopra, Rosy
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Tuz, Canan
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Vaes, Bert
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Viegas, Rita P. ...
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Vinker, Shlomo
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Wallis, Katharin ...
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Zeller, Andreas
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Gussekloo, Jacob ...
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Poortvliet, Rosa ...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Geriatrik
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Allmänmedicin
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