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September 14, 2026Canadian Family PhysicianOpen Access

Deprescribing statins for adults 65 years of age and older

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Why the study?

Does deprescribing statins improve outcomes or reduce harm in adults 65 years of age and older compared to continuation?

Population

Adults 65 years of age and older taking statins

Comparison

Deprescribing (discontinuation) of statins vs Continuation of statins

Design

Guideline

Key result

Statin deprescribing is suggested for older adults at the end of life, while statin continuation is suggested for primary and secondary prevention in older adults not at the end of life.

Authors

WTWade ThompsonABArden R. BarryLMLisa McCarthy

Discussion

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Overview

Supports individualized statin decisions in older adults; leaves open need for randomized trials to confirm net benefit.

Key Points

  • To develop an evidence-based clinical practice guideline assisting clinicians and older patients in deciding whether to continue or deprescribe statin therapy.
  • Developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework by a panel of 10 multidisciplinary clinicians and 1 public member, alongside a 5-member patient consultant group.
  • Synthesized evidence from reviews addressing the benefits, harms, feasibility, acceptability, equity, patient values, and resource implications of statin deprescribing versus continuation.
  • Recommends deprescribing statins in older adults who are at the end of life.
  • Suggests continuing statin therapy for both primary and secondary cardiovascular prevention in older adults who are not at the end of life.
  • Recommends tailored, shared decision-making informed by frailty, functional status, cognition, life expectancy, pill burden, and individual healthcare goals.

Structured PICO

Does deprescribing statins improve outcomes or reduce harm in adults 65 years of age and older compared to continuation?

P
Population
Adults 65 years of age and older who are currently taking and tolerating statins, evaluated for the benefits and harms of statin deprescribing versus continuation.
I
Intervention
Deprescribing (discontinuation) of statins
C
Comparator
Continuation of statins
O
Outcome
Benefits and harms of deprescribing versus continuation of statins

This guideline provides evidence-based recommendations for patient-centered decision-making regarding the continuation or deprescribing of statins in adults aged 65 and older.

Limitations

  • Lack of high-certainty clinical evidence on the benefits and harms of statin discontinuation compared with continuation, particularly outside of the end-of-life context.
  • Risk of bias in nonrandomized studies evaluating statin discontinuation.
  • Few studies reported absolute risk of statin discontinuation.

Cite This Study

Thompson et al. (2026) conducted a review in Statin use in older adults. Statin deprescribing vs. Statin continuation was evaluated. Statin deprescribing is suggested for older adults at the end of life, while statin continuation is suggested for primary and secondary prevention in older adults not at the end of life.

synapsesocial.com/papers/6aa7afef79e9260bc85aac78https://doi.org/10.46747/cfp.7209534
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