Dyspnea is common amongst patients with serious, life-limiting medical conditions including cardiovascular disease, pulmonary disease and cancer. Polypharmacy is associated with falls, hospitalization and mortality in older persons. Targeting which medications are preferred for discontinuation remains a challenge. Statins are common in older patients and are prescribed to reduce risk for poor cardiovascular outcomes. There are currently no data exploring the potential impact of statins on dyspnea for patients with life limiting disease.
Given the high personal costs for patients and their caregivers, dyspnea is an important target for improving patient-centered care for patients with serious, life-limiting diseases. We propose a trajectory analysis to determine the optimal number of different trajectories for dyspnea in older patients with serious diseases. As an informal validation step, we will then describe hospitalization and mortality outcomes associated with the different groups. Finally, we will determine what impact polypharmacy, in general, and statin use, specifically, have on dyspnea trajectory.