Prior to the QMR

• Review the Quarterly Medication Review Deprescribing Focus – ASA and Statins for Primary Prevention
• Reassess all residents on ASA or statins. If using for primary prevention of cardiovascular (CV) disease, consider deprescribing.

During the QMR

For all residents on ASA:

• Determine the indication for low dose ASA
• Based on current evidence, consider discontinuing ASA if being used solely for primary prevention of CV disease

For all residents on statins:

• Determine whether the statin is being used for primary or secondary prevention of CV disease
• If being used for primary prevention, consider the benefits and harms of ongoing treatment:
  • Resident’s cardiovascular risk
  • Resident’s goal of care
  • Adverse events (see Table 1 – Statin Adverse Events on page 5)
  • Drug interactions
  • Pill burden/medication pass time; polypharmacy
  • Goals of care
• Consider discontinuing or decreasing the dose of statin being used for primary prevention of CV disease
• Assess if any of the other medications the resident is taking interacts with statins. Reducing the dose or stopping a statin may necessitate dose adjustments or monitoring of other medications the resident is taking