Survey of Statin Use in a Nursing Home Population

Abstract

Background: The clinical benefits in regards to various indications of statin therapy for secondary prevention have been widespread. However, the effects and benefits of such therapies in the elderly nursing home population are not well studied. Current data supporting use of statins includes elders with mean age of 66 years; 60-71 years; 75 years, and a maximum age 82 years. Objective/Aim: To review the use of statins in a nursing home population by evaluating patient factors such as: age, diagnosis, type and dosing of statin used, monitoring parameters, renal function and drug interactions. (Observed differences in prescribing patterns were also reviewed). Quality Improvement Methods: The survey used involved quantitative and qualitative retrospective chart review to obtain: Patient name, age, gender, and location. Other data collected included the type of statin therapy used, dose, any renal adjustment, and documentation of muscle soreness. Any pertinent labs were checked for appropriate monitoring of lipid panel, liver function, creatinine kinase level and kidney function. The concomitant use of medications, which are considered high risk when used with statins, was also assessed. Results: Out of the 183 nursing home residents reviewed, 32 were receiving regular statin therapy. The major indication for statin use was hyperlipidemia (68.8%), followed by coronary artery disease (46.9%) diabetic coronary artery disease (12.5%), and cerebral vascular disease (18.8%). Regular lipid monitoring was performed in 62.5 percent of the reviewed residents, while the remaining 37.5 percent were not adequately monitored, there was not even a single lipid panel included in their chart. LFTs were performed in majority of the patients (84.3%). Most evident was the lack of creatinine kinase level monitoring, with only one resident out of the 32 reviewed having creatinine kinase level checked. Also, there was no documentation to support that the most common side effect of statin therapy, muscle pain, was even assessed. Conclusions: Monitoring efficacy of drug exposure is a basic principle of best practices in geriatric pharmacotherapy, but is an ongoing concern in the nursing home population. Analysis includes statin use in palliative cohorts, inappropriate dosing, and discussion of appropriateness of statin use in the nursing home population. Author Disclosures: All authors have stated there are no disclosures to be made that are pertinent to this abstract.