ABSTRACT
Background: Some have advocated discontinuing statins in patients with life-limiting conditions. However, the extent of statin use at the end of life has yet to be described and whether statin prescribing may already be influenced by the presence of a recognizable, life-limiting condition is unknown.
Objective: To measure the prevalence of statin use during the last 6 months of life and determine if statin prescribing varies according to the presence of a recognizable, life-limiting condition.
Design: Matched, case-control trial nested within a retrospective, cohort study.
Setting/subjects: From 3031 VISN 11 patients who died in FY2004, we identified 1584 (52%) receiving statins at least 6 months before death. Of those, we identified 337 cases with a recognizable, life-limiting condition and 1247 controls matched on number of comorbidities, age, and socioeconomic status.
Analyses: We used survival analysis to test the relationship between days without statins and the presence of a life limiting condition, while controlling for pills supplied and comorbidity score.
Results: There was no significant difference in the time off statins between cases and controls even though the study was sufficiently powered to detect one.
Conclusions: These findings underscore a missed opportunity to reduce the therapeutic burden upon dying patients and limit health care spending.
