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Discontinuation of statin therapy in older people: does a cancer diagnosis make a difference? An observational cohort study using data linkage

OBJECTIVE: The aim was to examine statin discontinuation rates in a cohort of elderly Australians with newly diagnosed cancer using population-based secondary health data. DESIGN: Observational cohort study. SETTING: New South Wales, the largest jurisdiction in Australia. The Pharmaceutical Benefits...

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Autores principales: Stavrou, Efty P, Buckley, Nicholas, Olivier, Jake, Pearson, Sallie-Anne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Group 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3358623/
https://www.ncbi.nlm.nih.gov/pubmed/22614172
http://dx.doi.org/10.1136/bmjopen-2012-000880
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author Stavrou, Efty P
Buckley, Nicholas
Olivier, Jake
Pearson, Sallie-Anne
author_facet Stavrou, Efty P
Buckley, Nicholas
Olivier, Jake
Pearson, Sallie-Anne
author_sort Stavrou, Efty P
collection PubMed
description OBJECTIVE: The aim was to examine statin discontinuation rates in a cohort of elderly Australians with newly diagnosed cancer using population-based secondary health data. DESIGN: Observational cohort study. SETTING: New South Wales, the largest jurisdiction in Australia. The Pharmaceutical Benefits and Repatriation Pharmaceutical Benefits Schemes are national programmes subsidising prescription drugs to the Australian population and Australian Government Department of Veterans' Affairs clients. PARTICIPANTS: The cohort comprised 1731 cancer patients aged ≥65 years with evidence of statin use in the 90 days prior to diagnosis. They were matched to 3462 non-cancer patients prescribed statins in the same period. MAIN OUTCOME MEASURE: The authors compared statin discontinuation rates up to 4 years post-diagnosis and examined the factors associated with statin discontinuation. RESULTS: The proportion of cancer patients discontinuing statin therapy at 4 years (27%) was comparable to the comparison cohort; however, significantly higher proportions of the cancer cohort discontinued statins than the comparison cohort at 3, 6 and 12 months of follow-up (9.7% vs 7.4% at 12 months, respectively). More than 30% of cancer patients who died were dispensed statins within 30 days of death. Discontinuation of statin therapy in cancer patients was associated with regionalised and distant disease spread at diagnosis (p<0.001), older age (p=0.006), upper gastrointestinal organs and liver cancer (aHR 2.95, 95% CI 1.92 to 4.53) and cancer of the lung, bronchus and trachea (aHR 1.99, 95% CI 1.32 to 3.00) and poorer survival. CONCLUSIONS: Medications should be rationalised at the time of a cancer diagnosis, especially in the setting of a poor prognosis. At least for some patients in our cohort, statin therapy may be inappropriately continued which adds unnecessarily to therapeutic burden.
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spelling pubmed-33586232012-05-31 Discontinuation of statin therapy in older people: does a cancer diagnosis make a difference? An observational cohort study using data linkage Stavrou, Efty P Buckley, Nicholas Olivier, Jake Pearson, Sallie-Anne BMJ Open Medical Management OBJECTIVE: The aim was to examine statin discontinuation rates in a cohort of elderly Australians with newly diagnosed cancer using population-based secondary health data. DESIGN: Observational cohort study. SETTING: New South Wales, the largest jurisdiction in Australia. The Pharmaceutical Benefits and Repatriation Pharmaceutical Benefits Schemes are national programmes subsidising prescription drugs to the Australian population and Australian Government Department of Veterans' Affairs clients. PARTICIPANTS: The cohort comprised 1731 cancer patients aged ≥65 years with evidence of statin use in the 90 days prior to diagnosis. They were matched to 3462 non-cancer patients prescribed statins in the same period. MAIN OUTCOME MEASURE: The authors compared statin discontinuation rates up to 4 years post-diagnosis and examined the factors associated with statin discontinuation. RESULTS: The proportion of cancer patients discontinuing statin therapy at 4 years (27%) was comparable to the comparison cohort; however, significantly higher proportions of the cancer cohort discontinued statins than the comparison cohort at 3, 6 and 12 months of follow-up (9.7% vs 7.4% at 12 months, respectively). More than 30% of cancer patients who died were dispensed statins within 30 days of death. Discontinuation of statin therapy in cancer patients was associated with regionalised and distant disease spread at diagnosis (p<0.001), older age (p=0.006), upper gastrointestinal organs and liver cancer (aHR 2.95, 95% CI 1.92 to 4.53) and cancer of the lung, bronchus and trachea (aHR 1.99, 95% CI 1.32 to 3.00) and poorer survival. CONCLUSIONS: Medications should be rationalised at the time of a cancer diagnosis, especially in the setting of a poor prognosis. At least for some patients in our cohort, statin therapy may be inappropriately continued which adds unnecessarily to therapeutic burden. BMJ Group 2012-05-21 /pmc/articles/PMC3358623/ /pubmed/22614172 http://dx.doi.org/10.1136/bmjopen-2012-000880 Text en © 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.
spellingShingle Medical Management
Stavrou, Efty P
Buckley, Nicholas
Olivier, Jake
Pearson, Sallie-Anne
Discontinuation of statin therapy in older people: does a cancer diagnosis make a difference? An observational cohort study using data linkage
title Discontinuation of statin therapy in older people: does a cancer diagnosis make a difference? An observational cohort study using data linkage
title_full Discontinuation of statin therapy in older people: does a cancer diagnosis make a difference? An observational cohort study using data linkage
title_fullStr Discontinuation of statin therapy in older people: does a cancer diagnosis make a difference? An observational cohort study using data linkage
title_full_unstemmed Discontinuation of statin therapy in older people: does a cancer diagnosis make a difference? An observational cohort study using data linkage
title_short Discontinuation of statin therapy in older people: does a cancer diagnosis make a difference? An observational cohort study using data linkage
title_sort discontinuation of statin therapy in older people: does a cancer diagnosis make a difference? an observational cohort study using data linkage
topic Medical Management
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3358623/
https://www.ncbi.nlm.nih.gov/pubmed/22614172
http://dx.doi.org/10.1136/bmjopen-2012-000880
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