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Life, death, and statins: association of statin prescriptions and survival in older general practice patients.
- Source :
-
Primary health care research & development [Prim Health Care Res Dev] 2024 May 16; Vol. 25, pp. e29. Date of Electronic Publication: 2024 May 16. - Publication Year :
- 2024
-
Abstract
- Aims: This study serves as an exemplar to demonstrate the scalability of a research approach using survival analysis applied to general practice electronic health record data from multiple sites. Collection of these data, the subsequent analysis, and the preparation of practice-specific reports were performed using a bespoke distributed data collection and analysis software tool.<br />Background: Statins are a very commonly prescribed medication, yet there is a paucity of evidence for their benefits in older patients. We examine the relationship between statin prescriptions for general practice patients over 75 and all-cause mortality.<br />Methods: We carried out a retrospective cohort study using survival analysis applied to data extracted from the electronic health records of five Australian general practices.<br />Findings: The data from 8025 patients were analysed. The median duration of follow-up was 6.48 years. Overall, 52 015 patient-years of data were examined, and the outcome of death from any cause was measured in 1657 patients (21%), with the remainder being censored. Adjusted all-cause mortality was similar for participants not prescribed statins versus those who were (HR 1.05, 95% CI 0.92-1.20, P = 0.46), except for patients with diabetes for whom all-cause mortality was increased (HR = 1.29, 95% CI: 1.00-1.68, P = 0.05). In contrast, adjusted all-cause mortality was significantly lower for patients deprescribed statins compared to those who were prescribed statins (HR 0.81, 95% CI 0.70-0.93, P < 0.001), including among females (HR = 0.75, 95% CI: 0.61-0.91, P < 0.001) and participants treated for secondary prevention (HR = 0.72, 95% CI: 0.60-0.86, P < 0.001). This study demonstrated the scalability of a research approach using survival analysis applied to general practice electronic health record data from multiple sites. We found no evidence of increased mortality due to statin-deprescribing decisions in primary care.
Details
- Language :
- English
- ISSN :
- 1477-1128
- Volume :
- 25
- Database :
- MEDLINE
- Journal :
- Primary health care research & development
- Publication Type :
- Academic Journal
- Accession number :
- 38751186
- Full Text :
- https://doi.org/10.1017/S1463423624000161