Performance Measurement Network

Question: Statin therapy for patients 75yrs and older

I have had some reluctance from a physician to prescribe statins for patients over the age of 75yrs. The physician states there is no supporting literature that states it is helpful in this population. I have looked on the AHA website and it does mention the benefit of statins for individuals bt the ages of 40-75, however I cannot find any supporting research/literature to provide this physician for patients over 75yrs. I've read the JC manual that does not have age as an exclusion criteria and I was hoping you can provide any literature that states the prescribing of statins in patients over 75yrs and what I can tell my physician who is looking for a reason other than because The Joint Commission does not have it as an exclusion.

Answer:

If the physician decides that statin therapy is inappropriate for the patient because age > 75 Y/O or ANY other reason, then he/she needs to document that in the medical record and the case will be excluded from the denominator. Age greater than 75 Y/O is not a stand-alone reason for exclusion because statins are not contraindicated for all patients > 75 Y/O. The evidence supports that in individuals greater than 75 years of age, the potential for ASCVD risk reduction benefits, adverse effects, drug-drug interactions, and patient preferences should be considered, and statin therapy individualized based on these considerations (Stone, 2013.)

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical
Related documents: STK, Reason for Not Prescribing Statin Medication at Discharge,
Manual: Current Manual (current data collection period; prior to data transmission)

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