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    National Trends in Statin Use among the United States Nursing Home Population (2011-2016)

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    Authors
    Mack, Deborah
    Hume, Anne L.
    Tjia, Jennifer
    Lapane, Kate L.
    UMass Chan Affiliations
    Clinical and Population Health Research Program, Graduate School of Biomedical Sciences
    Division of Epidemiology, Department of Population and Quantitative Health Sciences
    Document Type
    Journal Article
    Publication Date
    2021-03-11
    Keywords
    UMCCTS funding
    Geriatrics
    Health Services Administration
    Health Services Research
    Pharmaceutical Preparations
    
    Metadata
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    Link to Full Text
    https://doi.org/10.1007/s40266-021-00844-8
    Abstract
    BACKGROUND: Little is known about trends in statin use in United States (US) nursing homes. OBJECTIVES: The aim of this study was to describe national trends in statin use in nursing homes and evaluate the impact of the introduction of generic statins, safety warnings, and guideline recommendations on statin use. METHODS: This study employed a repeated cross-sectional prevalence design to evaluate monthly statin use in long-stay US nursing home residents enrolled in Medicare fee-for-service using the Minimum Data Set 3.0 and Medicare Part D claims between April 2011 and December 2016. Stratified by age (65-75 years, > /= 76 years), analyses estimated trends and level changes with 95% confidence intervals (CI) following statin-related events (the availability of generic statins, American Heart Association/American College of Cardiology guideline updates, and US FDA safety warnings) through segmented regression models corrected for autocorrelation. RESULTS: Statin use increased from April 2011 to December 2016 (65-75 years: 38.6-43.3%; > /= 76 years: 26.5% to 30.0%), as did high-intensity statin use (65-75 years: 4.8-9.5%; > /= 76 years: 2.3-4.5%). The introduction of generic statins yielded little impact on the prevalence of statins in nursing home residents. Positive trend changes in high-intensity statin use occurred following national guideline updates in December 2011 (65-75 years: beta = 0.16, 95% CI 0.09-0.22; > /= 76 years: beta = 0.09, 95% CI 0.06-0.12) and November 2013 (65-75 years: beta = 0.11, 95% CI 0.09-0.13; > /= 76 years: beta = 0.04, 95% CI 0.03-0.05). There were negative trend changes for any statin use concurrent with FDA statin safety warnings in March 2012 among both age groups (65-75 years: beta trend change = - 0.06, 95% CI - 0.10 to - 0.02; > /= 76 years: beta trend change = - 0.05, 95% CI - 0.08 to - 0.01). The publication of the results of a statin deprescribing trial yielded a decrease in any statin use among the > /= 76 years age group (beta level change = - 0.25, 95% CI - 0.48 to - 0.09; beta trend change = - 0.03, 95% CI - 0.04 to - 0.01), with both age groups observing a positive trend change with high-intensity statins (65-75 years: beta = 0.11, 95% CI 0.02-0.21; > /= 76 years: beta = 0.05, 95% CI 0.01-0.09). CONCLUSION: Overall, statin use in US nursing homes increased from 2011 to 2016. Guidelines and statin-related events appeared to impact use in the nursing home setting. As such, statin guidelines and messaging should provide special consideration for nursing home populations, who may have more risk than benefit from statin pharmacotherapy.
    Source

    Mack DS, Hume AL, Tjia J, Lapane KL. National Trends in Statin Use among the United States Nursing Home Population (2011-2016). Drugs Aging. 2021 Mar 11. doi: 10.1007/s40266-021-00844-8. Epub ahead of print. PMID: 33694105. Link to article on publisher's site

    DOI
    10.1007/s40266-021-00844-8
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/29744
    PubMed ID
    33694105
    Related Resources

    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1007/s40266-021-00844-8
    Scopus Count
    Collections
    Morningside Graduate School of Biomedical Sciences Scholarly Publications
    UMass Chan Faculty and Researcher Publications
    Population and Quantitative Health Sciences Publications
    UMass Center for Clinical and Translational Science Supported Publications

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