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dc.contributor.authorMack, Deborah
dc.contributor.authorHume, Anne L.
dc.contributor.authorTjia, Jennifer
dc.contributor.authorLapane, Kate L.
dc.date2022-08-11T08:08:26.000
dc.date.accessioned2022-08-23T15:55:23Z
dc.date.available2022-08-23T15:55:23Z
dc.date.issued2021-03-11
dc.date.submitted2021-04-23
dc.identifier.citation<p>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. <a href="https://doi.org/10.1007/s40266-021-00844-8">Link to article on publisher's site</a></p>
dc.identifier.issn1170-229X (Linking)
dc.identifier.doi10.1007/s40266-021-00844-8
dc.identifier.pmid33694105
dc.identifier.urihttp://hdl.handle.net/20.500.14038/29744
dc.description.abstractBACKGROUND: 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.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=33694105&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://doi.org/10.1007/s40266-021-00844-8
dc.subjectUMCCTS funding
dc.subjectGeriatrics
dc.subjectHealth Services Administration
dc.subjectHealth Services Research
dc.subjectPharmaceutical Preparations
dc.titleNational Trends in Statin Use among the United States Nursing Home Population (2011-2016)
dc.typeJournal Article
dc.source.journaltitleDrugs and aging
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/faculty_pubs/1957
dc.identifier.contextkey22628115
html.description.abstract<p>BACKGROUND: Little is known about trends in statin use in United States (US) nursing homes.</p> <p>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.</p> <p>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.</p> <p>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).</p> <p>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.</p>
dc.identifier.submissionpathfaculty_pubs/1957
dc.contributor.departmentClinical and Population Health Research Program, Graduate School of Biomedical Sciences
dc.contributor.departmentDivision of Epidemiology, Department of Population and Quantitative Health Sciences


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