Turner Justin P, Shakib Sepehr, Singhal Nimit, Hogan-Doran Jonathon, Prowse Robert, Johns Sally, Thynne Tilenka, Bell J Simon
Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia; School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia; Department of Clinical Pharmacology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
J Am Geriatr Soc. 2014 Oct;62(10):1900-5. doi: 10.1111/jgs.13051. Epub 2014 Oct 3.
To investigate statin use and pain in people with cancer aged 70 to 79 and 80 and older.
Cross-sectional.
Medical oncology outpatient clinic at the Royal Adelaide Hospital.
Individuals aged 70 and older who presented consecutively between January 2009 and June 2010 (n = 385), of whom 106 were aged 80 and older.
Participants completed a structured data collection instrument, documenting medication use, comorbidities and a general pain assessment (10-point visual analogue scale (VAS)). Unadjusted and adjusted logistic regression was used to compute odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with statin use.
The prevalence of statin use was 35% (n = 97) in people aged 70 to 79 and 39% (n = 41) in those aged 80 and older. After adjusting for age, sex, Charlson Comorbidity Index, and analgesic use, statin use was associated with self-reported pain (VAS ≥ 5) (OR = 4.09, 95% CI = 1.32-12.68) in people aged 80 and older but not in those aged 70 to 79. Half of participants using statins (51% n = 70) had a palliative treatment approach. Of the 41 statin users aged 80 and older, 20 (49%) were using statins for primary prevention.
The prevalence of statin use was similar in people aged 70 to 79 years and those aged 80 and older, with statin use associated with self-reported pain in people aged 80 and older. This highlights a potential benefit of "deprescribing" statins in older people with cancer, especially those aged 80 and older.
调查70至79岁及80岁及以上癌症患者使用他汀类药物的情况及疼痛情况。
横断面研究。
皇家阿德莱德医院肿瘤内科门诊。
2009年1月至2010年6月期间连续就诊的70岁及以上个体（n = 385），其中106人年龄在80岁及以上。
参与者完成一份结构化数据收集工具，记录用药情况、合并症和一般疼痛评估（10分视觉模拟量表（VAS））。使用未调整和调整后的逻辑回归计算与他汀类药物使用相关因素的比值比（OR）和95%置信区间（CI）。
70至79岁人群中他汀类药物的使用率为35%（n = 97），80岁及以上人群中为39%（n = 41）。在调整年龄、性别、查尔森合并症指数和镇痛药物使用后，80岁及以上人群中他汀类药物使用与自我报告的疼痛（VAS≥5）相关（OR = 4.09，95%CI = 1.32 - 12.68），而70至79岁人群中则无此关联。使用他汀类药物的参与者中有一半（51%，n = 70）采用姑息治疗方法。在41名80岁及以上的他汀类药物使用者中，20人（49%）使用他汀类药物进行一级预防。
70至79岁人群与80岁及以上人群中他汀类药物的使用率相似，80岁及以上人群中他汀类药物使用与自我报告的疼痛相关。这凸显了在老年癌症患者，尤其是80岁及以上患者中“停用”他汀类药物的潜在益处。
