Majeed A, Moser K, Maxwell R
Office for National Statistics, London.
J Public Health Med. 2000 Sep;22(3):275-9. doi: 10.1093/pubmed/22.3.275.
Statins are highly effective in reducing the risk of sudden cardiac death and other acute coronary events in patients with pre-existing ischaemic heart disease or with raised blood cholesterol levels. However, relatively little is known about how statins are used in primary care. The objectives of this study were to investigate age, sex and inter-practice variations in the prescribing of statins.
This was an observational study of statin prescribing rates in 288 general practices in England and Wales that contributed data to the General Practice Research Database in 1996.
In 1996, 0.7 per cent of men and 0.5 per cent of women received a prescription for a statin. In the subgroup of patients with a general practitioner (GP) diagnosis of ischaemic heart disease, 13.3 per cent of men and 8.2 per cent of women received a prescription for a statin in 1996. Below the age of 65 years, men with ischaemic heart disease were more likely to be prescribed a statin than were women. Patients aged 75 years and over with ischaemic heart disease were unlikely to be prescribed a statin irrespective of their sex. The percentage of patients prescribed statins in individual practices varied from 0.1 to 2.3 per cent in men and from 0 to 2.3 per cent in women. The recorded prevalence of ischaemic heart disease explained only 12 per cent of this variation in men and 7 per cent in women.
There are large age, sex and inter-practice variations in the use of statins in primary care, which are poorly explained by measures of health need. Developing and implementing clinical guidelines to accompany the introduction of new drugs for the management of common chronic disorders should be seen as a priority for GPs, primary care groups and the National Institute of Clinical Excellence.
他汀类药物在降低已有缺血性心脏病或血胆固醇水平升高患者的心源性猝死及其他急性冠脉事件风险方面具有高效性。然而，关于他汀类药物在基层医疗中的使用情况，人们了解得相对较少。本研究的目的是调查他汀类药物处方中的年龄、性别及不同医疗机构间的差异。
这是一项对英格兰和威尔士288家全科诊所他汀类药物处方率的观察性研究，这些诊所在1996年向全科医疗研究数据库提供了数据。
1996年，0.7%的男性和0.5%的女性接受了他汀类药物处方。在全科医生（GP）诊断为缺血性心脏病的患者亚组中，1996年13.3%的男性和8.2%的女性接受了他汀类药物处方。65岁以下患有缺血性心脏病的男性比女性更有可能被开他汀类药物。75岁及以上患有缺血性心脏病的患者，无论性别，都不太可能被开他汀类药物。各医疗机构中接受他汀类药物处方的男性患者比例在0.1%至2.3%之间，女性患者比例在0至2.3%之间。记录的缺血性心脏病患病率仅解释了男性中这一差异的12%，女性中的7%。
基层医疗中他汀类药物的使用存在较大的年龄、性别及不同医疗机构间的差异，健康需求指标对这些差异的解释力较弱。制定并实施临床指南以配合引入用于管理常见慢性疾病的新药，应被视为全科医生、基层医疗团体及国家临床优化研究所的优先事项。
