Chaiyakunapruk Nathorn, Asuphol Olarik, Dhippayom Teerapon, Poowaruttanawiwit Prayuth, Jeanpeerapong Napawan
Center of Pharmaceutical Outcomes Research (CPOR) Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences Pharmaceutical Care Research Unit, Naresuan University Buddhachinnaraj Hospital, Phitsanulok, Thailand.
Int J Pharm Pract. 2011 Apr;19(2):129-35. doi: 10.1111/j.2042-7174.2010.00089.x. Epub 2011 Feb 14.
To determine statin usage pattern and evaluate whether new generation statins are actually needed by the patients receiving them.
This retrospective cohort included patients receiving first-time statins at a tertiary care hospital in Thailand. Using electronic medical records from 2005, its indication was determined based on history of coronary heart disease (CHD) and CHD-risk equivalents. The lipid profiles tested within 30 days prior to the first date of statins prescription were analysed. Each patient was assessed as to whether statin was needed based on low-density lipoprotein cholesterol (LDL-C) reduction capacity and lipid goals.
A total of 2479 first-time statin users was included. Ninety percent of the users received simvastatin, while 8% and 2% received atorvastatin and pravastatin respectively. More than half (58.0%) used statins for primary prevention, although all usage of atorvastatin was considered not needed. Considering the use of statin for secondary prevention to achieve the LDL-C goal of <130mg/dl (3.37mmol/l), more than 80% of atorvastatin users could be switched to simvastatin. Only 8% of simvastatin usage would not be able to achieve this target. When the LDL-C goal was <70mg/dl (1.81mmol/l), 40.2% simvastatin users was considered appropriate, while 58.6% needed atorvastatin to be prescribed.
A substantial proportion of patients did not need statins therapy, particularly for primary prevention. In addition, atorvastatin use is mostly not needed except in patients requiring statins for secondary prevention to achieve the LDL-C goal of <70mg/dl (1.81mmol/l). The findings should prompt hospital policy makers to develop measures to ensure the proper use of statins in their clinical settings.
