Barriers for statin prescription in real-world clinical practice (results of a survey among Krasnodar City and Krasnodar Region doctors)
Abstract
Aim. To identify main barriers for statin prescription by doctors in real-world clinical practice.
Material and methods. In total, 568 doctors from Krasnodar City and Krasnodar Region were surveyed on possible reasons for inadequate statin prescription.
Results. About 50 % of the doctors were afraid of possible statin hepatotoxicity and one third - of potential adverse effects. About 20 % believed that target lipid levels could be achieved by diet only. The vast majority (80 %) did not prescribe statins due to "high cost".
Conclusion. Clinician-oriented educational programs on lipid-lowering therapy should be continued. The emphasis should be put on statin therapy safety, its lipid-lowering and pleiotropic effects, as well as on the importance of achieving target lipid levels in various clinical situations.
About the Authors
V. V. Skibitsky
Kuban State Medical University
Russian Federation
Russian Federation
A. V. Fendrikova
Kuban State Medical University
Russian Federation
Russian Federation
N. A. Spiropulos
Krasnodar City Clinical Hospital of Emergency Care. Krasnodar
Russian Federation
Russian Federation
N. I. Oleynik
Kuban State Medical University
Russian Federation
Russian Federation
D. V. Sirotenko
Kuban State Medical University
Russian Federation
Russian Federation
References
1. Van Ganse Е., Laforest L., Alemao E. et al. Lipid-modifying therapy and attainment of cholesterol goals in Europe: the Return on Expenditure Achieved for Lipid Therapy (REALITY) study. Curr Med Res Opin 2005; 21(9): 1389-99.
2. Сусеков А.В. Розувастатин -новый ингибитор ГМГ-КоА редуктазы. Предварительные данные по эффективности и безопасности. Сердце 2004; 3(3): 137-45.
3. Шальнова С.А., Деев А.Д. Характеристика пациентов высокого риска. Результаты эпидемиологической части научно-образовательной программы ОСКАР. Кардиоваск тер профил 2006; 5(5): 58-63.
4. Сусеков А.В., Зубарева М.Ю., Деев А.Д. и др. Основные результаты Московского Исследования по Статинам (Moscow Statin Survey, MSS). Сердце 2006; 5(6): 324-8.
5. Garnett W.R. Interaction with hydroxymethylglutaryl-coenzym A reductase inhibitors. Am J Health Syst Pharm 1995; 52: 1639-44.
6. Kastrup E.K. Drug Facts and Comparisons. St. Louis, Facts and Comparisons 2000, pp 536-42.
7. Graham D.J., Staffa J.A., Shatin D. et al. Incidence of hospitalized rhabdomyolysis in patients treated with lipid-lowering drugs. JAMA 2004; 292: 2585-90.
8. Pierce R.L., Wysowki D.K., Gross T.P. Myopathy and rhabdomyolysis associated with lovaststin-gemfibrozil combination therapy. JAMA 1990; 264: 71-5.
9. Schech S., Graham D.J., Staffa J.A. et al. Risk factors for statin-associated rhabdomyolysis. Pharmacoepidemiol Drug Saf 2007; 16(3): 352-8.
10. The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). NIH Publication 2002; T-8.
11. Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20536 highrisk patients: a randomized placebocontroiled trial. Lancet 2002; 360: 722.
12. Brown B.G., Zhao X-Q., Chait A. et al. Simvastatin and Niacin, Antioxidant Vitamins, or the Combination for the Prevention of Coronary Disease. N Engl J Med 2001; 345: 1583-92.
13. Hippisley-Cox J., Coupland C. Effect of combinations of drugs on all cause mortality in patients with ischaemic heart disease: nested case-control analysis. BMJ 2005; 330: 1059-63.
14. Laupacis A., Mamdani M. Observational studies of treatment effectiveness: some caution. Ann Intern Med 2004; 140: 923-4.
15. Colhoun M.H., Betteridge D.J., Durrington P.N. et al. Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentre randomised placebo-controlled trial. Lancet 2004; 364(9435): 685-96.
16. Sever P.S., Dahlof B., Pouter N.R. et al. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardie Outcomes Trial -Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet 2003; 361: 1149-58.
17. Illingworth D.R. Management of hypercholesterolemia. Mad Clin North Am 2000; 84: 23-42.
18. Оганов P.Г., Лепахин В.К., Фитилев С.Б. и др. Вторичная профилактика ишемической болезни сердца у пациентов, перенесших инфаркт миокарда, на примере московской популяции. Кардиоваск тер профил 2005; 3(часть 1): 53-60.
Review
For citations:
Skibitsky V.V., Fendrikova A.V., Spiropulos N.A., Oleynik N.I., Sirotenko D.V. Barriers for statin prescription in real-world clinical practice (results of a survey among Krasnodar City and Krasnodar Region doctors). Cardiovascular Therapy and Prevention. 2008;7(3):89-94. (In Russ.)
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