Prescribing trends of statins in Scotland: A drug utilization study

Authors

  • Asadul M. Helali Division of Applied Health Sciences, Institute of Child Health, University of Aberdeen, Scotland
  • James McLay Division of Applied Health Sciences, Institute of Child Health, University of Aberdeen, Scotland
  • Isa Naina Mohamed Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia

DOI:

https://doi.org/10.3329/bjp.v8i4.16772

Keywords:

LDL-C, Incidence, Prevalence, Simvastatin, Statin

Abstract

Statins are highly effective in managing hypercholesterolaemia in patients with or without chronic heart disease due to extensive evidence for safety, efficacy and cost effectiveness. Observational cross sectional retrospective cohort study was done in approximately 200 primary care practices in Scotland. Frequency, rates and time trends for statin prescriptions together with demographic data and the prescribing patterns for high dose simvastatin and newer statins in its place was measured. 63%, 27%, 5%, 4% and 1% patients were prescribed simvastatin, atorvastatin, pravastatin, rosuvastatin and fluvastatin respectively (n=1,91370). Prevalence for individual statin as well as for all statin prescriptions, significantly increased (p<0.05). Except rosuvastatin the incidence of other statins prescription significantly decreased (p<0.05). The highest number of patients, 884 (24%) switched to atorvastatin from high dose simvastatin. Increase in prevalent use and decrease in incident use of statins, implies the diminished cardiovascular disease related mortality and subsequent increased life expectancy of patients with cardiovascular disease.

Downloads

Download data is not yet available.
Abstract
431
Download
120 Read
1

Author Biography

Asadul M. Helali, Division of Applied Health Sciences, Institute of Child Health, University of Aberdeen, Scotland

Assistant Professor

References

Arnlov J, Pencina JM, Amin S, Nam B, Benjamin JE, Murabito MJ et al. Endogenous sex hormones and cardiovascular disease incidence in men. Ann Intern Med. 2006; 145: 176-84.

Bruckert E, Hayem G, Dejager S, Yau C, Begaud B. Mild to moderate muscular symptoms with high-dosage statin therapy in hyperlipidemic patients: The PRIMO study. Cardiovasc Drugs Ther. 2005; 19: 403-14.

Cannon CP, McCabe CH, Belder R, Breen J, Braunwald E. Design of the pravastatin or atorvastatin evaluation and infection therapy (PROVE IT)-TIMI 22 trial. Am J Cardiol. 2002; 89: 860-61.

Cappuccio FP, Wilson K, Lacey LA, Marchant N. Management of hyperlipidemia in the UK: An estimation of the level of controlled achieved. J Outcomes Res. 2005; 9: 1-14.

Catapano A, Brady WK, King TR, Palmisano J. Lipid altering-efficacy of ezetimibe co-administered with simvstatin compared with rosuvastatin: A meta-analysis of pooled data from 14 clinical trials. Curr Med Res Opin. 2005; 21: 1123-30.

Connor P, Feely J, Shepherd J. Lipid lowering drugs. BMJ. 1990; 300: 667-72.

Crouse JR. An evaluation of rosuvastatin: Pharmacokinetics, clinical efficacy and tolerability. Drug Metab Toxicol. 2008; 4: 287-94.

Davidson MH, Robinson JG. Safety of aggressive lipid management. J Am Coll Cardiol. 2007; 49: 1753-62.

Davies AR, Smeeth L, Grundy EMD. Contribution of changes in incidence and mortality to trends in the prevalence of coronary heart disease in the UK: 19962005. Eur Heart J. 2007; 28: 2142-47.

Deedwania P, Stone PH, Merz CN, Cosin-Aguilar J, Koylan N, Luo D et al. Effects of intensive versus moderate lipid-lowering therapy on myocardial ischemia in older patients with coronary heart disease: Results of the Study Assessing Goals in the Elderly (SAGE). Circulation 2007; 115: 700-07.

Grundy SM, Cleeman JI, Merz CN, Brewer B. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation 2004; 110: 227-39.

Hobbs FDR, Southworth H. Achievement of english national service framework lipid lowering goals: Pooled data from recent comparative treatment trials of statins at starting doses. Int J Clin Pract. 2005; 59: 1171-77.

Izzat L. The MERCURY II trial: Benefits of rosuvastatin. BJDVD. 2006; 6: 171-74.

Jackevicius CA, Tu K, Filate WA. Trends in cardiovascular drug utilization and drug expenditures in Canada between 1996 and 2001. Can J Cardiol. 2003; 19: 1359-66.

Kanavos P. Do generics offer significant savings to the UK National Health Service? Curr Med Res Opin. 2007; 23: 105-16.

Kucera Z, Vlcek J, Hejdova M. Theoretical exposure of chronically treated patients to lipid lowering agents. Pharmacoepidemiol Drug Saf. 2005; 14: 61-67.

Lemos JA, Blazing MA, Wiviott SD, Lewis EF, Fox KAA, White HD et al. Early intensive vs a delayed conservative simvastatin strategy in patients with acute coronary syndromes phase Z of the A to Z trial. JAMA. 2004; 292: 1307-16.

Magrini N, Einarson T, Vaccheri A. Use of lipid-lowering drugs from 1990 to 1994: An international comparison among Australia, Finland, Italy, Norway and Sweden. Eur J Clin Pharmacol. 1997; 53: 185-89.

Mason CM. Preventing coronary heart disease and stroke with aggressive statin therapy in older adults using a team management model. J Am Acad Nurse Pract. 2009; 21: 47-53.

Maycock CA, Muhlestein JB, Horne BD, Carlquist JF, Bair TL, Pearson RR et al. Statin therapy is associated with reduced mortality across all age groups of individuals with significant coronary disease, including very elderly patients. JACC. 2002; 40: 1777-85.

McDonald KJ, Jardine AG. The use of fluvastatin in cardiovascular risk management. Expert Opin Pharmacother. 2008; 9: 1407-14.

Mcelduff P, Jaefarnezhad M, Durrington PN. American, British and European recommendations for statins in the primary prevention of cardiovascular disease applied to British men studied prospectively. Heart 2006; 92: 1213-18.

Milias GA, Panagiotakos DB, Pitsavos C, Xenaki D, Panagopoulos G, Stefanadis C. Prevalence of self-reported hypercholesterolaemia and its relation to dietary habits, in Greek adults; a national nutrition & health survey. Lipids Health Dis. 2006; 5: 5.

Mohamed IN, Helms PJ, Simpson CR, Mclay JS. Using routinely collected prescribing data to determine drug persistence for the purpose of pharmacovigilance. J Clin Pharmacol. 2011; 51: 279-84.

Ohsfeldt RL, Gandhi SK, Fox KM, McKenney JM. Statin cost-effectiveness comparisons using real-world effectiveness data: Formulary implications. Value Health 2008; 11: 1061-69.

Packham C, Pearson J, Robinson J, Gray D. Use of statins in general practices, 1996-8: Cross sectional study. BMJ 2000; 320: 1583-84.

Pedersen TR, Faergeman O, Kastelein JJP et al. High-dose atorvastatin vs. usual-dose simvastatin for secondary prevention after myocardial infarction: the IDEAL study: A randomized controlled trial. JAMA 2005; 294: 2437-45.

Petty D, Lloyd D. Can cheap generic statins achieve national cholesterol lowering targets? J Health Serv Res Policy 2008; 13: 99-102.

Rosa JCL, Grundy SM, Waters DD, Shear C, Barter P, Fruchart JC et al. Treating to new targets (TNT) investigators: Intensive lipid lowering with atorvastatin in patients with stable coronary disease. N Engl J Med. 2005; 352: 1425-35.

Schuster H, Barter PJ, Stender S, Cheung RC, Bonnet J, Jonathan M et al. Effects of switching statins on achievement of lipid goals: Measuring effective reductions in cholesterol using rosuvastatin therapy (MERCURY I) study. AHJ 2004; 147: 705-12.

Shepherd J, Blauw GJ, Murphy MB, Bollen ELEM, Buckley BM, Cobbe SM et al. Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomised controlled trial. Lancet 2002; 360: 1623-30.

Shepherd J, Cobbe SM, Ford I, Isles CG, Lorimer AR, MacFarlane PW et al. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. West of Scotland coronary prevention study group (WOSCOPS). N Engl J Med. 1995; 333: 1301-07.

Simpson CR, Hannaford PC, Williams D. Evidence for inequalities in the management of coronary heart disease in Scotland. Heart 2005; 91: 630-34.

Stein EA, Laskarzewski P. Comparison of Statins in Hypertriglyceridemia. Am J Cardiol. 1998; 81: 66-69.

Study of the effectiveness of additional reductions in cholesterol and homocysteine (SEARCH) collaborative group: Intensive lowering of LDL cholesterol with 80 mg versus 20 mg simvastatin daily in 12064 survivors of myocardial infarction: A double-blind randomised trial. Lancet 2010; 376: 1658-69.

Toth PP, Cadman CJ. Implications of recent statin trials for primary care practice. J Clin Lipidol. 2007; 1: 182-90.

Weng TC, Yang YKH, Lin SJ, Tai SH. A systematic review and meta-analysis on the therapeutic equivalence of statins. J Clin Pharm Ther. 2010; 35: 139-51.

Wilson K, Marriott J, Fuller S, Lacey L, Gillen D. A model to assess the cost effectiveness of statins in achieving the UK national service framework target cholesterol levels. Pharmacoeconomics 2003; 21: 1-11.

Published

2013-12-09

How to Cite

Helali, A. M., J. McLay, and I. N. Mohamed. “Prescribing Trends of Statins in Scotland: A Drug Utilization Study”. Bangladesh Journal of Pharmacology, vol. 8, no. 4, Dec. 2013, pp. 401-9, doi:10.3329/bjp.v8i4.16772.

Issue

Section

Research Articles