Evidence map›Paper›PMID 32057091›Full record

ArticleJournal of the American Geriatrics Society2020

Prevalent Statin Use in Long-Stay Nursing Home Residents with Life-Limiting Illness.

Deborah S Mack, Jennifer Tjia, Anne L Hume, Kate L Lapane

Open access · greenAbstract readEvaluation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Geriatrics Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 24% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

  1. Pooled it
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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

4 authors at 2 institutions in 1 country.

Deborah S MackDivision of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.ORCID 0000-0002-8619-0364
Jennifer TjiaDivision of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
Anne L HumeDepartment of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston, Rhode Island.
Kate L LapaneDivision of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
University of Massachusetts Chan Medical School · USUniversity of Rhode Island · US

Funding

University of Massachusetts Center for Clinical and Translational ScienceTL1TR001454 · NCATS · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI LEWIS, BRIAN C · 2015 to 2024
$3.6M
Use and safety of statins among nursing home residents with life-limiting illness in the United StatesR36HS026840 · AHRQ · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI MACK, DEBORAH · 2019 to 2019
$43k
AHRQ HHS R36 HS026840NCATS NIH HHS TL1 TR001454
6 · The paper itself

Abstract

objectivesTo evaluate the prevalence and factors associated with statin pharmacotherapy in long-stay nursing home residents with life-limiting illness.

designCross-sectional.

settingUS Medicare- and Medicaid-certified nursing home facilities.

participantsLong-stay nursing home resident Medicare fee-for-service beneficiaries aged 65 years or older with life-limiting illness (n = 424 212). MEASUREMENTS: Prevalent statin use was estimated as any low-moderate intensity (daily dose low-density lipoprotein-cholesterol [LDL-C] reduction <30%-50%) and high-intensity (daily dose LDL-C reduction >50%) use via Medicare Part D claims for a prescription supply on September 30, 2016, with a 90-day look-back period. Life-limiting illness was operationally defined to capture those near the end of life using evidence-based criteria to identify progressive terminal conditions or limited prognoses (<6 mo). Poisson models provided estimates of adjusted prevalence ratios and 95% confidence intervals for resident factors.

resultsA total of 34% of residents with life-limiting illness were prescribed statins (65-75 y = 44.0%, high intensity = 11.1%; >75 y = 31.1%, high intensity = 5.4%). Prevalence of statins varied by life-limiting illness definition. Of those with a prognosis of less than 6 months, 23% of the 65 to 75 and 12% of the older than 75 age groups were on statins. Factors positively associated with statin use included minority race or ethnicity, use of more than five concurrent medications, and atherosclerotic cardiovascular disease or risk factors.

conclusionDespite having a life-limiting illness, more than one-third of clinically compromised long-stay nursing home residents remain on statins. Although recent national guidelines have expanded indications for statins, the benefit of continued therapy in an advanced age population near the end of life is questionable. Efforts to deprescribe statins in the nursing home setting may be warranted. J Am Geriatr Soc 68:708-716, 2020.

Indexed as

AgedAged, 80 and overChronic DiseaseCross-Sectional StudiesDrug UtilizationFemaleHomes for the AgedHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleNursing HomesPalliative CarePolypharmacyUnited StatesHydroxymethylglutaryl-CoA Reductase Inhibitorsend of lifenursing homespharmacotherapystatins

Identifiers

PMID32057091
PMCPMC8072406
OpenAlexW3006488755

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.