The Pharmaceutical Journal
Vol 270 No 7241 p392
22 March 2003

This article
Reprint
Photocopy

News summary

Related websites
Heart abstract (more)

Older patients still missing out on statins despite rise in prescribing

Many patients who need statins are not receiving them despite increases in the number of prescriptions for lipid lowering drugs, report researchers from St George's Hospital Medical School, London.

Professor Derek Cook, of the department of public health sciences, and colleagues, tracked statin prescribing from 1994 to 2001 using data from 142 general practices in England and Wales, analysing the records of around 30,000 patients with ischaemic heart disease a year.

Prescribing patterns varied widely among practices but overall the researchers found that prescriptions for lipid lowering drugs for these patients rose from less than 10 per cent in 1994 to over 50 per cent in 2001.

Although statins accounted for nearly all of this increase, by the end of 2001 only 56 per cent of eligible men and 41 per cent of eligible women had been prescribed a statin. Furthermore, one in three of them were prescribed a dose that was too low.

The researchers say that the type of heart disease and patient age appeared to be the most important factors that influenced statin use. In 1998, 44.9 per cent of patients aged 35–64 years received a statin compared with 10.4 per cent of those aged 75–84 years. Revascularised patients were more likely to receive a statin than patients with angina, suggesting that doctors perceive coronary artery procedures as being more significant than angina.

"As the purpose of lipid lowering drugs in ischaemic heart disease is secondary prevention, it is clearly just as important that patients with angina receive lipid lowering drugs as revascularised patients," the researchers say.

They also point out that although general practitioners are more willing to prescribe lipid lowering drugs than they were five years ago, "there is room for improvement in a number of areas". They suggest that although the National Service Framework for Coronary Heart Disease will help to reduce variations in prescribing practice and address the needs of those with angina, the elderly are still likely to miss out (Heart 2003;89:417).