Evidence map›Paper›PMID 30652277›Full record

ArticleJournal of general internal medicine2019

Patient Characteristics and General Practitioners' Advice to Stop Statins in Oldest-Old Patients: a Survey Study Across 30 Countries.

Milly A van der Ploeg, Sven Streit, Wilco P Achterberg, Erna Beers, Arthur M Bohnen, Robert A Burman, Claire Collins, Fabio G Franco, Biljana Gerasimovska-Kitanovska, Sandra Gintere and 31 more

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In one paragraph

Article in Journal of general internal medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05178420 (Discontinuing Statins in Multimorbid Older Adults Without Cardiovascular Disease), which is not on this map. Cited by 12 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 2 pooled it
18.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05178420 nacompletednot on this mapstarted 2021, after this paper: background citation

Discontinuing Statins in Multimorbid Older Adults Without Cardiovascular Disease (STREAM) - a Randomized Non-inferiority Clinical Trial

TypeinterventionalSponsorInsel Gruppe AG, University Hospital BernRan2021 to 2026Enrolled1,880ConditionsStatin Treatment for Primary PreventionArmsStatin discontinuation
3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 39 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

41 authors at 20 institutions in 24 countries.

Milly A van der PloegDepartment of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, 2333 ZD, Leiden, The Netherlands.
Sven StreitInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Wilco P AchterbergDepartment of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, 2333 ZD, Leiden, The Netherlands.
Erna BeersDepartment of Family Medicine, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, The Netherlands.
Arthur M BohnenDepartment of General Practice, Erasmus Medical Center, Rotterdam, The Netherlands.
Robert A BurmanVennesla Primary Health Care Centre, Bergen, Norway.
Claire CollinsIrish College of General Practitioners, Dublin, Ireland.
Fabio G FrancoHospital Israelita Albert Einstein, São Paulo, Brazil.
Biljana Gerasimovska-KitanovskaDepartment of Nephrology and Department of Family Medicine, University Clinical Centre, University St. Cyril and Metodius, Skopje, Macedonia.
Sandra GintereFaculty of Medicine, Department of Family Medicine, Riga Stradiņs University, Riga, Latvia.
Raquel Gomez BravoInstitute for Health and Behaviour, Research Unit INSIDE, University of Luxembourg, Luxembourg City, Luxembourg.
Kathryn HoffmannDepartment of General Practice and Family Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria.
Claudia IftodeTimis Society of Family Medicine, Sano Med West Private Clinic, Timisoara, Romania.
Sanda Kreitmayer PeštićDepartment for Family Medicine, Health Center Tuzla, Medical School, University of Tuzla, Tuzla, Bosnia and Herzegovina.
Tuomas H KoskelaDepartment of General Practice, University of Tampere, Tampere, Finland.
Donata KurpasFamily Medicine Department, Wroclaw Medical University, Wrocław, Poland.
Hubert MaisonneuvePrimary Care Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Christan D MallenPrimary Care and Health Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK.
Christoph MerloInstitute of Primary and Community Care Lucerne (IHAM), Lucerne, Switzerland.
Yolanda MuellerDepartment of Community Care and Ambulatory Medicine, Institute of Family Medicine Lausanne (IUMF), Lausanne, Switzerland.
Christiane MuthGoethe-University, Institute of General Practice, Frankfurt/Main, Germany.
Ferdinando PetrazzuoliCenter for Primary Health Care Research, Clinical Research Center, Lund University, Malmö, Sweden.
Nicolas RodondiInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Thomas RosemannInstitute of Primary Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Martin SattlerSSLMG, Societé Scientifique Luxembourgois en Medicine generale, Luxembourg City, Luxembourg.
Tjard SchermerDepartment of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.
Marija Petek ŠterDepartment of Family Medicine, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
Zuzana ŠvadlenkováOrdinace Řepy, s.r.o., Prague, Prague, Czech Republic.
Athina TatsioniResearch Unit for General Medicine and Primary Health Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Hans ThulesiusDepartment of Clinical Sciences, Section of Family Medicine, Lund University, Malmö, Sweden.
Victoria TkachenkoDepartment of Family Medicine, Institute of Family Medicine at Shupyk National Medical Academy of Postgraduate Education, Kiev, Ukraine.
Péter TorzsaDepartment of Family Medicine, Semmelweis University, Budapest, Hungary.
Rosy TsopraAP-HP, Assistance Publique des Hôpitaux de Paris, Université Paris 13, Paris, France.
Canan TuzErzincan University Family Medicine Department, Erzincan, Turkey.
Bert VaesDepartment of Public Health and Primary Care, Universiteit Leuven (KU Leuven), Leuven, Belgium.
Rita P A ViegasDepartment of Family Medicine, NOVA Medical School, Lisbon, Portugal.
Shlomo VinkerSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Katharine A WallisDepartment of General Practice & Primary Health Care, School of Population Health Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
Andreas ZellerCentre for Primary Health Care (uniham-bb), University of Basel, Basel, Switzerland.
Jacobijn GusseklooDepartment of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, 2333 ZD, Leiden, The Netherlands.
Rosalinde K E PoortvlietDepartment of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, 2333 ZD, Leiden, The Netherlands. R.K.E.Poortvliet@lumc.nl.
Leiden University Medical Center · NLAmsterdam University Medical Centers · NLAssistance Publique – Hôpitaux de Paris · FRErasmus MC · NLErzincan University · TRGoethe University Frankfurt · DEHospital Israelita Albert Einstein · BRKeele University · GBKU Leuven · BELund University · SEMedical University of Vienna · ATRadboud University Medical Center · NLRiga Stradiņš University · LVSemmelweis University · HUShupyk National Healthcare University of Ukraine · UASocietà Italiana di Medicina Generale · ITTampere University · FITel Aviv University · ILUniversidade Nova de Lisboa · PTUniversity Clinical Centre · PL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStatins 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.

objectiveTo 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.

designWe 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 (OR KEY

resultsTwo 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 (OR

conclusionsThe 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.

Indexed as

InternationalitySurveys and QuestionnairesAged, 80 and overCardiovascular DiseasesCase-Control StudiesFemaleGeneral PractitionersHumansHydroxymethylglutaryl-CoA Reductase InhibitorsLife ExpectancyMalePractice Patterns, Physicians'Withholding TreatmentHydroxymethylglutaryl-CoA Reductase Inhibitorscardiovascular diseasesclinical decision-makingdrug therapygeneral practitionershydroxymethylglutaryl-CoA reductase inhibitorspalliative care

Identifiers

PMID30652277
PMCPMC6711940
OpenAlexW2909851367

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.