RESUMO
Background: There is little evidence for statins for primary cardiovascular prevention in older adults. Consequently, it is important to assess patient attitudes toward the use of statins, which might differ from attitudes toward other medications. We aimed to describe older patient attitudes toward deprescribing statins versus general medications. Methods: We conducted a survey using the revised Patients' Attitudes Toward Deprescribing questionnaire in its original version and adapted to statin use in adults ≥65 years taking a statin for primary prevention. Results: Among the 47 participants (mean age 74.6 years), 42 (89%) were satisfied with their current therapy, but still willing to stop ≥1 of their medications upon their doctor's advice. About 68% (N = 32) were satisfied with their statin therapy, while 83% (N = 39) would accept to consider deprescribing. Twenty-six (55%) participants were concerned about missing future benefits when stopping their general medications and 17 (36%) when stopping their statin. Eight (17%) participants believed they were experiencing side effects of statins and twice as many for general medication (38%, N = 18). Conclusion: Our study provides insight about differences and similarities in patient attitudes toward deprescribing general medications and statins in primary prevention. This information could support patient-centered conversations and shared-decision making about deprescribing.
RESUMO
Dyslipidemia is a modifiable risk factor for cardiovascular diseases. Recommendations are based on achieving LDL-C target levels, but it is essential to assess the benefits of intensifying lipid-lowering therapy in terms of absolute risk reduction of cardiovascular events across different risk groups. Current data on the absolute benefits of the latest lipid-lowering treatments are more limited in comparison with statins. A recent analysis showed that adding a second lipid-lowering treatment only reduces the absolute cardiovascular risk in patients at very high and high cardiovascular risk, without a substantial benefit in patients at moderate or low cardiovascular risk, as mentioned in the recent recommendations free of conflict of interest and published in the British Medical Journal.
La dyslipidémie est un facteur de risque modifiable des maladies cardiovasculaires. Les recommandations sont basées sur l'atteinte de valeurs cibles du LDL-C mais il est essentiel d'évaluer les avantages de l'intensification du traitement hypolipémiant en termes de réduction du risque absolu d'événements cardiovasculaires dans les différents groupes à risque. Les données actuelles sur le bénéfice des nouveaux traitements hypolipémiants sont plus limitées comparées aux statines. Une analyse récente a montré que l'addition d'un second traitement hypolipémiant réduit le risque cardiovasculaire (CV) absolu uniquement chez les patients avec un risque CV très élevé ou élevé, sans bénéfice absolu substantiel chez les patients à risque CV modéré ou faible, ce qui a été repris des recommandations internationales sans conflit d'intérêts dans le British Medical Journal.
