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Discontinuation of Statins FREE

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The full report is titled “Discontinuation of Statins in Routine Care Settings. A Cohort Study.” It is in the 2 April 2013 issue of Annals of Internal Medicine (volume 158, pages 526-534). The authors are H. Zhang, J. Plutzky, S. Skentzos, F. Morrison, P. Mar, M. Shubina, and A. Turchin.

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Ann Intern Med. 2013;158(7):I-40. doi:10.7326/0003-4819-158-7-201304020-00001
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What is the problem and what is known about it so far?

Doctors frequently prescribe statins to lower blood cholesterol levels in people who have elevated cholesterol levels. In research studies, only a small proportion of people develop tiredness, muscle aches, or other symptoms that could be caused by statins, and even fewer stop taking their statins because of these symptoms. In practice, however, many more people stop taking statins because of symptoms that may be related to their statins and, thus, do not benefit from lower cholesterol levels.

Why did the researchers do this particular study?

The researchers created a software program that can read the unstructured text that clinicians enter in the electronic medical record to describe clinical visits. Then they showed that the software reliably identifies information about why people stop taking statins, in addition to the information that is available in the lists of diagnoses, allergies, and other structured parts of the electronic medical record.

Who was studied?

More than 100,000 adults who received a statin prescription during a 9-year period, beginning in 2000.

How was the study done?

Researchers used their software to find out who had statin-related events, whether people stopped taking their statins after these events, whether they later restarted a statin, and what happened if they did.

What did the researchers find?

Approximately one fifth of people had a symptom or other event that may have been related to the drug, and more than one half of these people stopped taking their statin, at least temporarily. More than one half of the people who stopped because of an event started taking a statin again (although not necessarily the same one), and more than 90% of them continued taking the statin after restarting.

What were the limitations of the study?

The study was done at 1 academic health system, which may limit the conclusions to similar settings. The software is not perfectly accurate.

What are the implications of the study?

Many statin-related events may be caused by something other than the statin, may be caused by the statin but are tolerable, or may be caused by 1 statin but not others.





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