Marked Variations in Statin Use in Nursing Home Residents
High-outlying prescribing physicians had higher historical rates of statin prescribing.
HealthDay News — Statin prescribing is considerable among nursing home residents, with significant variation in prescribing seen across physicians, according to a study published in the Journal of the American Geriatrics Society.
Michael A. Campitelli, MPH, from the Institute for Clinical Evaluative Sciences in Toronto, and colleagues conducted a population-based cross-sectional analysis involving 631 nursing home facilities to examine the variability of statin use among adults age 66 years and older residing in a nursing home facility.
The researchers found that 33.6% of the 76,226 nursing home residents assigned to 1919 physicians were statin users. Among the 44,290 residents categorized as frail, 30.1% were statin users.
Compared with non-frail residents, frail residents were significantly less likely to be statin users in an adjusted model (adjusted odds ratio, 0.62; 95% confidence interval, 0.58 to 0.65). Between-physician variability accounted for 9.1% of the residual unexplained variation in statin use (P <.001), after adjustment for resident characteristics. More low-outlying and high-outlying prescribers of statins were seen than expected by chance (17.4% and 12.0%, respectively) among the 894 physicians assigned 20 or more residents. High-outlying prescribing physicians had higher historical rates of statin prescribing.
"Further studies are required to evaluate the risks and benefits of statin use, and discontinuation, among nursing home residents to better inform clinical practice in this setting," the authors write.
Campitelli MA, Maxwell CJ, Giannakeas V, et al. The variation of statin use among nursing home residents and physicians: a cross-sectional analysis [published online August 9, 2017]. J Am Geriatr Soc. doi: 10.1111/jgs.15013.