Short summary

Statins are medications used to lower the chance of developing cardiovascular disease (such as a heart attack). People often take statins for many years. A statin may be a good choice when it was started. However, as people age into their 80s and 90s it may make sense to think about stopping it in some circumstances. This decision should be carefully discussed between patients and their doctors. We want to find out what GPs think is important to talk about with patients when considering this decision.  

Rationale

There is compelling evidence for the benefit of statins in secondary prevention of cardiovascular disease (CVD) and in primary prevention of CVD for persons at high risk of future events. However, the potential benefit of statins in persons over the age of 80 is not clear, particularly in people who have multiple medical problems, are frail, and are taking many medications. 
People often take statins for many years. A statin may have been started in a person's 60s or 70s, and this person may continue on the statin into their 80s or 90s. Over this time, the person's health context may have changed a lot. As such, the balance of benefit and harm of the statin may change, along with a persons healthcare goals and treatment preferences. Given limited evidence of benefit and a person's changing healthcare context, it may make sense to think about potential deprescribing (planned, supervised discontinuation) of the statin for some older people. Available guidance suggests that this decision be individualized and incorporate factors such as a patient's overall health and function, goals and preferences, cardiovascular history, level of frailty, and concomitant medication use. The eventual decision should be shared between a patient/family member and physician. This likely requires a careful discussion in order to make sure the best decision can be made. However, it is currently unclear how Danish GPs are approaching the discussion and what they feel is important to communicate with patients regarding the decision. 
This knowledge is important to understand how to optimize communication around statin deprescribing. The aim of our study is to investigate what GPs feel is important to discuss with patients when considering statin deprescribing. 

Description of the cohort

Danish general practitioners (GPs) 

Data and biological material

GP preferences for discussing statin deprescribing with patients (via a discrete choice experiment)

Collaborating researchers and departments

Research Unit of General Practice, University of Southern Denmark 

• Professor Dorte Jarbøl
• Professor Jesper Bo Nielsen
• Associate Professor Line Bjørnskov Pedersen
• Post-doctoral Fellow Peter Haastrup
• Post-doctoral Fellow Jette Videbæk Le

Research Unit of Clinical Pharmacology and Pharmacy, University of Southern Denmark

Hospital Pharmacy Funen, Odense University Hospital

• Associate Professor Anton Pottegård