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Letters to the Editor
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Statins
Many people do not take statins as described
From Mr J. Knowles, MRPharmS
It is important that a pharmacist takes the utmost care when publicly
supporting an advertisement feature placed in The Pharmaceutical
Journal (5/12 January 2008), particularly when that pharmacist is employed by
the NHS to give prescribing advice.
The Journal insert advertising ezetimibe is a case in point. No mention
is made of patient compliance. Those of us working in primary care often
encounter patients whose cholesterol levels are not on target because
they do not take their statin as prescribed.
There are many reasons for poor compliance, and primary care pharmacists
are in a good position to explore these and find solutions. Similarly,
community pharmacists can help with judicious use of medicines use reviews.
I am disappointed that Omar Ali omitted this important issue in his article.
The advertisement feature uses a five-year-old survey published in the
British Journal of Cardiology to support its claim that “35
per cent of patients with coronary heart disease in the UK are not reaching
government cholesterol targets despite effective treatment therapies”.
There
is no mention in the survey of the statin doses used except to say that
the figure improved to 22 per cent after review of statin treatment.
This hardly supports the advertisement feature’s claim.
Mr Ali also omitted to mention the fact that ezetimibe has no robust
cardiovascular disease outcome data, in contrast to a number of statins.
This should be taken into account when deciding which path to follow
when a patient is not to target.
The National Institute for Clinical Excellence clearly explains the place
of ezetimibe in treatment. I agree with Mr Ali that anyone who requires
clarification should log on to the
website or may
wish to discuss the issue with a medicines management pharmacist. Contact
with such pharmacists can be made by contacting local primary care trusts.
John Knowles
Locality Lead Pharmacist
Walsall Teaching Primary Care
Trust |
The
Pharmaceutical Journal