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Statin use and pain in older people with cancer: a cross-sectional study
Justin P Turner1, Sepehr Shakib, Nimit Singhal
1Centre 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.
Objectives:
To investigate statin use and pain in people with cancer aged 70 to 79 and 80 and older.
Design:
Cross-sectional.
Setting:
Medical oncology outpatient clinic at the Royal Adelaide Hospital.
Participants:
Individuals aged 70 and older who presented consecutively between January 2009 and June 2010 (n = 385), of whom 106 were aged 80 and older.
Measurements:
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.
Results:
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.
Conclusion:
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.
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