SAN FRANCISCO, June 5 (Xinhua) -- New research suggests patients nearing the end of their lives because of a "life-limiting illness" may not feel medically abandoned if their doctor wants to take them off drugs that control their cholesterol.
Jon Furuno, an associate professor in the Oregon State University (OSU)/Oregon Health & Science University College of Pharmacy, joined collaborators from around the United States in a study that included nearly 300 patients whose average age was 72 and whose life expectancy was one to 12 months.
With a life-limiting condition such as cancer or heart disease, the patients, as participants in a clinical trial to determine the safety and benefit of discontinuing statin therapy, gave responses to a nine-item questionnaire designed to quantify potential benefits and concerns.
Fifty-eight percent of them were cancer patients, 8 percent had cardiovascular disease, and 30 percent had some other life-limiting diagnosis.
Statins are a class of drugs that work by blocking the liver enzyme responsible for cholesterol production, thus reducing the buildup of plaque on artery walls that can lead to a stroke or heart attack.
The drugs are highly effective but not without side effects for some patients, the most common being muscle pain that ranges from mild to severe.
"We know these patients are on a lot of medications," Furuno said. "There's a lot of concern that patients will feel like doctors are giving up on them if they start to discontinue some of their medications, that there's something comforting about continuing to take their medications, and this gives us some indication of what patients feel about the risks and benefits of deprescribing."
As results of the study, published in the monthly Journal of Palliative Medicine, less than 5 percent of participants expressed concern that deprescribing statins indicated being abandoned by their doctor, and many could see benefits of going off their statin, including spending less on medications (63 percent); the potential for being able to stop taking other meds also (34 percent); and having a better overall quality of life (25 percent).
And cardiovascular patients were particularly likely to envision quality-of-life benefits arising from statin discontinuation.
"As a patient's prognosis changes and we think they have a relatively short lifespan left, it really requires risk/benefit re-examination of everything we're doing for them, medications and everything else. There may still be benefits, but have the benefits changed or has the risk/benefit ratio changed?" Furuno said in a news release from OSU.
He acknowledged that "this group is likely not completely representative of all people, because they might be foreseeing some benefits to stopping that other people hadn't considered."
Nevertheless, Furuno and his collaborators believe that the findings are important because little is known about the best way to manage chronic medications for patients with a life-limiting condition.
