Format

Send to

Choose Destination
See comment in PubMed Commons below
Ann Intern Med. 2013 Apr 2;158(7):526-34. doi: 10.7326/0003-4819-158-7-201304020-00004.

Discontinuation of statins in routine care settings: a cohort study.

Author information

  • 1Key Laboratory of Endocrinology, Ministry of Health, PekingUnion Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.

Abstract

BACKGROUND:

Systematic data on discontinuation of statins in routine practice of medicine are limited.

OBJECTIVE:

To investigate the reasons for statin discontinuation and the role of statin-related events (clinical events or symptoms believed to have been caused by statins) in routine care settings.

DESIGN:

A retrospective cohort study.

SETTING:

Practices affiliated with Brigham and Women's Hospital and Massachusetts General Hospital in Boston.

PATIENTS:

Adults who received a statin prescription between 1 January 2000 and 31 December 2008.

MEASUREMENTS:

Information on reasons for statin discontinuations was obtained from a combination of structured electronic medical record entries and analysis of electronic provider notes by validated software.

RESULTS:

Statins were discontinued at least temporarily for 57 292 of 107 835 patients. Statin-related events were documented for 18 778 (17.4%) patients. Of these, 11 124 had statins discontinued at least temporarily; 6579 were rechallenged with a statin over the subsequent 12 months. Most patients who were rechallenged (92.2%) were still taking a statin 12 months after the statin-related event. Among the 2721 patients who were rechallenged with the same statin to which they had a statin-related event, 1295 were receiving the same statin 12 months later, and 996 of them were receiving the same or a higher dose.

LIMITATIONS:

Statin discontinuations and statin-related events were assessed in practices affiliated with 2 academic medical centers. Utilization of secondary data could have led to missing or misinterpreted data. Natural-language-processing tools used to compensate for the low (30%) proportion of reasons for statin discontinuation documented in structured electronic medical record fields are not perfectly accurate.

CONCLUSION:

Statin-related events are commonly reported and often lead to statin discontinuation. However, most patients who are rechallenged can tolerate statins long-term. This suggests that many of the statin-related events may have other causes, are tolerable, or may be specific to individual statins rather than the entire drug class.

PRIMARY FUNDING SOURCE:

National Library of Medicine, Diabetes Action Research and Education Foundation, and Chinese National Key Program of Clinical Science.

[PubMed - indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Silverchair Information Systems Icon for PubMed Central
    Loading ...
    Support Center