MDNews - Cleveland-Akron-Canton

M ANY INDIVIDUALS AND their families cope with significant burdens imposed by serious illness in the final months of life. How to best support their quality of life is an important care consideration. Research can play a vital role in provid- ing answers that will guide and shape the science of palliative care for current and future generations of patients and their families. Although much research has been focused on keeping people healthy or restoring them to health, few clinical trials have been devoted to improving outcomes for individuals with life-defining illnesses. Analyzing the continuation versus discontinuation of statins for hospice patients was the focus of a recent study by the Palliative Care Research Cooperative Group (PCRC). Statins are a group of drugs that help patients lower their serum cholesterol levels. By doing so, patients are less likely to develop block- ages in their arteries and they might then avoid having a heart attack or a stroke. But are these drugs still helpful when a person has only a few months to live? Medicines can be expensive, ill patients often have a difficult time swallowing their pills, and medication side effects can occur. A drug intended to prevent a heart attack may not show much benefit if a person has only a few weeks or months left to live. In this study, patients were enrolled in one of two groups. One group con- tinued to take statins and the other group did not. The PCRC established t he goa l of enrolling 360 patients nationwide within a two-year period. The study closed with a total enrollment of 380 patients. Hospice of the Western Reserve began participating in the study in October of 2012. A total of 16 patients enrolled and participated throughout the six months. The study's primar y purpose was to determine if there is a difference in survival time between patients with advanced life-limiting illness for whom statins are discontinued and patients who are maintained on the medication. The group that stopped taking statins did not experience an increase in heart attacks or strokes, their median time until death was actually longer, and they had a better quality of life. The clinical question of whether to continue or discontinue statins in the last year of life remains a patient-centered decision, where clinicians and patients together talk about what to do. However, our clinicians can now feel confident in recommending to hospice patients that they can safely discontinue one of their medications if they so choose. For m ore inf or m at ion a b out thi s study, visit http://abstracts.asco.org/144/ AbstView_144_135132.html. C harles Wellman, MD, FA A HPM, is Chief Medical Of f icer of Hospice of the Western Reser ve, a member of the Palliative Care Research Cooperative (PCRC). He is board certified in internal medicine and hospice and palliat ive medicine, and has been practicing in the f ield of hospice and palliative medicine for 30 years. A regionally and nationally recognized expert in pain and symptom control, end-of-life communication, and hospice organization and management, he presents widely on these topics. Through Hospice of the Western Reserve's Hospice Institute, which coordinates all the orga- nization's research professional education efforts, he has reportedly mentored and taught thousands of medical, social work, therapy and pharmacy students. ■ Discontinuing Statins By Charles V. Wellman, MD, FAAHPM an Option for Hospice Patients ++++++++++++++++++++++++++++++++ + +++ + +++ ++++++++++++++++++++++++++++++++ SPECIAL SECTION: CANCER 3 0 | Cleveland/Akron/Canton MD NEWS ■ M D N E W S . CO M ■ N OV E M B E R / D E C E M B E R 2 0 1 4

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