OhioHealth Physician Co-Authors National Clinical Trial
Research study involving Dr. Charles F. von Gunten was published in “JAMA Internal Medicine”
COLUMBUS, Ohio – Charles F. von Gunten, MD, PhD, Vice President, Medical Affairs, Hospice & Palliative Care at OhioHealth was among a group of physicians in a nationwide study to find that discontinuing statin use in patients with late-stage cancer and other terminal illnesses may help improve patients’ quality of life without causing other adverse health effects.
The finding was published in JAMA Internal Medicine on March 23. It indicates that care for patients with advanced illness can be improved by discontinuing some therapies that are primarily preventive for other health concerns.
“I’m proud to have been part of setting up the Palliative Care Research Cooperative and participating in its first multi-site study,” Dr. von Gunten said. “This evidence is a concrete example of the much larger issue of people taking medicines that make sense earlier in life or the course of an illness, that no longer make sense later in life or near the end of an illness.”
Statins are among the most commonly prescribed medications in the United States with more than 25 percent of the nation’s Medicare beneficiaries receiving statin therapy. These medications are usually taken to lower cholesterol and reduce the risk of heart attack or stroke. The benefits of statins typically take two years to accrue.
The study evaluated 381 patients. About half of them discontinued statins, while the other half continued the therapy.
The average age of the patients was 74 years old and nearly half of them had cancer. The median survival time for the entire study population was 219 days and the proportion of participants who died within 60 days was not significantly different between the groups that continued or discontinued statin therapy.
The study’s results address significant concerns related to end-of-life health care. In the last year of life, the number of medicines increases by 50 percent, so reducing the number of medications may relieve the pill burden on some patients. Also, more than 80 percent of Americans are expected to die of chronic illnesses, primarily cardiovascular disease, cancer, dementia and chronic lung disease. Because statins are effective in primary prevention of cardiovascular disease, the number of patients on the therapy is expanding and it is frequently continued until the end of patients’ life.
The authors say that their study should prompt physicians to discuss the uncertain benefit and possible harm of continuing statin therapy for people with life-limiting illness and functional decline.
“For patients with shorter life expectancy, greater concern about pill burden, and more comfort-oriented goals of care,” said the authors. “Physicians may endorse discontinuing statins as a means to reduce the number of medications without apparent harmful effects on survival or quality of life.”
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