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Patient Characteristics and General Practitioners' Advice to Stop Statins in Oldest-Old Patients: a Survey Study Across 30 Countries
MA. van der Ploeg, S. Streit, WP. Achterberg, E. Beers, AM. Bohnen, RA. Burman, C. Collins, FG. Franco, B. Gerasimovska-Kitanovska, S. Gintere, R. Gomez Bravo, K. Hoffmann, C. Iftode, SK. Peštić, TH. Koskela, D. Kurpas, H. Maisonneuve, CD....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články
NLK
Free Medical Journals
od 1997 do Před 1 rokem
PubMed Central
od 1997 do Před 1 rokem
Europe PubMed Central
od 1997 do Před 1 rokem
ProQuest Central
od 1997-01-01 do Před 1 rokem
Medline Complete (EBSCOhost)
od 1998-01-01 do Před 1 rokem
Nursing & Allied Health Database (ProQuest)
od 1997-01-01 do Před 1 rokem
Health & Medicine (ProQuest)
od 1997-01-01 do Před 1 rokem
Health Management Database (ProQuest)
od 1997-01-01 do Před 1 rokem
- MeSH
- internacionalita * MeSH
- kardiovaskulární nemoci farmakoterapie epidemiologie MeSH
- lékařská praxe - způsoby provádění normy trendy MeSH
- lidé MeSH
- naděje dožití trendy MeSH
- nenasazení léčby normy trendy MeSH
- praktičtí lékaři normy trendy MeSH
- průzkumy a dotazníky * normy MeSH
- senioři nad 80 let MeSH
- statiny aplikace a dávkování škodlivé účinky MeSH
- studie případů a kontrol MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
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.
AP HP Assistance Publique des Hôpitaux de Paris Université Paris 13 Paris France
Centre for Primary Health Care University of Basel Basel Switzerland
Department of Family Medicine Medical Faculty University of Ljubljana Ljubljana Slovenia
Department of Family Medicine NOVA Medical School Lisbon Portugal
Department of Family Medicine Semmelweis University Budapest Hungary
Department of General Practice Erasmus Medical Center Rotterdam The Netherlands
Department of General Practice University of Tampere Tampere Finland
Department of Primary and Community Care Radboud University Medical Center Nijmegen The Netherlands
Department of Public Health and Primary Care Universiteit Leuven Leuven Belgium
Erzincan University Family Medicine Department Erzincan Turkey
Faculty of Medicine Department of Family Medicine Riga Stradiņs University Riga Latvia
Family Medicine Department Wroclaw Medical University Wrocław Poland
Goethe University Institute of General Practice Frankfurt Main Germany
Hospital Israelita Albert Einstein São Paulo Brazil
Institute of Primary and Community Care Lucerne Lucerne Switzerland
Institute of Primary Care University Hospital Zurich University of Zurich Zurich Switzerland
Institute of Primary Health Care University of Bern Bern Switzerland
Irish College of General Practitioners Dublin Ireland
Ordinace Řepy s r o Prague Prague Czech Republic
Primary Care and Health Sciences Keele University Keele Staffordshire ST5 5BG UK
Primary Care Unit Faculty of Medicine University of Geneva Geneva Switzerland
Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
SSLMG Societé Scientifique Luxembourgois en Medicine generale Luxembourg City Luxembourg
Timis Society of Family Medicine Sano Med West Private Clinic Timisoara Romania
Citace poskytuje Crossref.org
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- $a van der Ploeg, Milly A $u Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, 2333 ZD, Leiden, The Netherlands.
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- $a Patient Characteristics and General Practitioners' Advice to Stop Statins in Oldest-Old Patients: a Survey Study Across 30 Countries / $c MA. van der Ploeg, S. Streit, WP. Achterberg, E. Beers, AM. Bohnen, RA. Burman, C. Collins, FG. Franco, B. Gerasimovska-Kitanovska, S. Gintere, R. Gomez Bravo, K. Hoffmann, C. Iftode, SK. Peštić, TH. Koskela, D. Kurpas, H. Maisonneuve, CD. Mallen, C. Merlo, Y. Mueller, C. Muth, F. Petrazzuoli, N. Rodondi, T. Rosemann, M. Sattler, T. Schermer, MP. Šter, Z. Švadlenková, A. Tatsioni, H. Thulesius, V. Tkachenko, P. Torzsa, R. Tsopra, C. Tuz, B. Vaes, RPA. Viegas, S. Vinker, KA. Wallis, A. Zeller, J. Gussekloo, RKE. Poortvliet,
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- $a 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.
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- $a Gomez Bravo, Raquel $u Institute for Health and Behaviour, Research Unit INSIDE, University of Luxembourg, Luxembourg City, Luxembourg.
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