Age, sex and practice variations in the use of statins in general practicein England and Wales

Background Statins are highly effective in reducing the risk of sudden card iac death and other acute coronary events in patients with pre-existing isc haemic heart disease or with raised blood cholesterol levels. However, rela tively little is known about how statins are used in primary care. The obje ctives of this study were to investigate age, sex and inter-practice variat ions in the prescribing of statins. Methods 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. Results In 1996, 0.7 per cent of men and 0.5 per cent of women received a p rescription for a statin. In the subgroup of patients with a general practi tioner (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 t he 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 irrespectiv e 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 cen t in women. The recorded prevalence of ischaemic heart: disease explained o nly 12 per cent of this variation in men and 7 per cent in women. Conclusions There are large age, sex and inter-practice variations in the u se of statins in primacy care, which are poorly explained by measures of he alth need. Developing and implementing clinical guidelines to accompany the introduction of new drugs for the management of common chronic disorders s hould be seen as a priority for GPs, primary care groups and the National I nstitute of Clinical Excellence.