Deprescribing statins in older adults: new evidence-based clinical practice guideline

The deprescribing.org team has developed a new evidence-based clinical practice guideline for deprescribing statins in older adults. The guideline is designed to support healthcare professionals in making decisions regarding whether a statin should be continued or deprescribed (i.e., discontinued) in their older patients (≥ 65 years). The guideline does not specifically focus on statin intolerance management (although it is discussed) or make recommendations about initiating statins in older adults, as these topics are addressed by existing guidelines.The statin deprescribing guideline was developed by a panel of 10 clinicians (family physicians, pharmacists, a geriatrician, a cardiologist, a neurologist, a nurse practitioner) and one patient/public member. The panel also obtained feedback from a patient/public consultant group of five people ≥ 65 years taking statins. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach was used for guideline development. The recommendations in the statin deprescribing guideline evolved following evidence reviews on the benefits/harms of deprescribing versus continuation of statins in older adults. The panel also took into consideration the feasibility, acceptability, equity and patient preferences related to statin deprescribing and the resource implications of statin deprescribing. The panel stresses that for older adults not at end-of-life, statin discontinuation might be associated with a higher chance of adverse outcomes compared with continuation, but there is great uncertainty. However, for older adults at end-of-life, there is probably no difference in mortality at 60 days or cardiovascular events at one year for statin discontinuation compared with continuation.RecommendationsThe statin deprescribing guideline recommendations apply to adults ≥ 65 years of age who are taking and tolerating statins. All recommendations received unanimous support from the panel members.All decisions should be tailored to the individual and include a conversation with patients/carers.Decisions may be informed by consideration of the patient’s function, mobility, cognition, level of frailty, social circumstances, life expectancy and pill burden, as well as patient values, preferences and healthcare goals. The panel suggests: deprescribing (i.e., discontinuing) statins in older adults at end-of-life, i.e., those with advanced, life-limiting illness and life expectancy < 12 months (conditional recommendation, low certainty evidence)continuing statins for primary prevention in older adults who are not at end-of-life (conditional recommendation, very low certainty evidence)continuing statins for secondary prevention in older adults who are not at end-of-life (conditional recommendation, very low certainty evidence)offering a conversation about continuing or discontinuing statins for select patients (ungraded good practice statement).The guideline includes a two-page statin deprescribing algorithm. It summarizes the factors that may warrant a discussion about discontinuing a statin in an older adult, conversation points for engaging patients and carers about deprescribing, and how to incorporate frailty and life expectancy into decisions.The deprescribing.org team also offers a series of three videos about the statin deprescribing guideline and algorithm, and case examples illustrating how they can be used in practice.Overall, the statin deprescribing guideline supports patient-centred decision-making regarding statin use in older adults. The recommendations are intended to be discussed together with patients/carers to reach decisions about statin use that reflect individual patient characteristics, values, preferences and healthcare goals.References:Thompson W, Barry AR, McCarthy LM, et al. Deprescribing statins for older persons: an evidence-based clinical practice guideline. (accessed May 19, 2026). Deprescribing.org. Statin deprescribing algorithm. September, 2025. (accessed May 19, 2026).

Deprescribing statins in older adults: new evidence-based clinical practice guideline

Register for free access or login.

Related Topics