Mainous Arch G, Baker Richard, Everett Charles J, King Dana E
Department of Family Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.
Qual Prim Care. 2010;18(5):301-6.
allowing statins to be sold without a prescription has been widely debated in Great Britain, Canada and the USA.
To examine the impact of the recent policy in Great Britain allowing patients to purchase over-the-counter (OTC) 10 mg dose of a cholesterol-lowering drug (simvastatin) on meeting the needs of individuals at moderate risk of coronary heart disease (CHD).
we undertook an analysis of adults (aged >20 years) in the nationally representative 2006 Health Survey for England (HSE, n =10 007). We evaluated the proportion of individuals using OTC statins among all adults aged 20 years and over and among individuals eligible for them according to current guidelines.
among adults in the HSE, 44.1% met the criteria for referral to a general practitioner for CHD risk, 9.7% were eligible for OTC statins and 46.1% did not meet the eligibility for prescribed or OTC statin therapy. Less than 1% (0.7%) were taking OTC statins. The proportion of individuals using OTC statins among those eligible for them was low and comparable to that in the overall population (0.2%). Among those taking OTC statins, 71.5% were also taking prescribed lipid lowering agents.
these results suggest that the aim of addressing the treatment gap among individuals at moderate risk by offering access to OTC statins has not been achieved two years after the implementation of the policy.
在英国、加拿大和美国,允许他汀类药物无需处方即可销售一直存在广泛争议。
研究英国最近允许患者非处方购买10毫克剂量的降胆固醇药物(辛伐他汀)这一政策对满足冠心病(CHD)中度风险个体需求的影响。
我们对具有全国代表性的2006年英格兰健康调查(HSE,n = 10007)中的成年人(年龄>20岁)进行了分析。我们评估了20岁及以上所有成年人中以及根据现行指南符合使用非处方他汀类药物条件的个体中使用非处方他汀类药物的比例。
在HSE的成年人中,44.1%符合因冠心病风险而转诊至全科医生的标准,9.7%符合使用非处方他汀类药物的条件,46.1%不符合处方或非处方他汀类药物治疗的条件。服用非处方他汀类药物的不到1%(0.7%)。符合使用非处方他汀类药物条件的个体中使用该药物的比例较低,与总体人群中的比例相当(0.2%)。在服用非处方他汀类药物的人群中,71.5%也在服用处方降脂药。
这些结果表明,在该政策实施两年后,通过提供非处方他汀类药物来解决中度风险个体治疗缺口的目标尚未实现。