Many 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 for Hospice of the Western Reserve.  Research can play a vital role in providing 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. Hospice of the Western Reserve became a member of the Palliative Care Research Cooperative (PCRC) to address the need for more evidence-based research. Prior to becoming a partner in the study, we verified that the protocol was reviewed and approved by an accredited Institutional Research Board, and that all the procedures were in place to ensure that patients, their physicians, and families were fully informed of the pros and cons of participation and able to make informed decisions.

Study Examines Continuation Versus Discontinuation of Statins

One of the Cooperative's first studies focused on analyzing the continuation versus discontinuation of statins for hospice patients. Statins are a group of drugs that help patients to lower their serum cholesterol levels. By doing so, patients are less likely to develop blockages 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 continued to take their statin and the other group did not. The PCRC established the goal 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 Oct 2012. A total of 16 patients enrolled and participated throughout the six months. The study's primary 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.

 Study Results

The group that stopped taking their 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 our hospice patients that they can safely discontinue one of their meds if they so choose.*

Hospice of the Western Reserve will continue to participate in clinical research that can lead to genuine progress in palliative care and a better quality of life for patients at the end of life. 


*Full details of the study will be available upon publication.