Changes in the utilisation of lipid-lowering drugs over a 6-year period (1993-1998) in a Danish population

Objective: The effect of lipid-lowering drugs (LLDs) on coronary heart dise ase is well established. However, their utilisation is often suspected to b e too low. The aim of this study was to describe the epidemiology of LLD us e with special emphasis on the development of utilisation over a 6-year per iod in a Danish population. Methods: For all people who purchased LLDs from 1993 to 1998 in Funen Count y, all prescriptions for LLDs and co-medication with cardiovascular and ant idiabetic drugs were retrieved from Odense University Pharmacoepidemiologic Database (OPED). Results: During the study period, LLD use increased nearly exponentially. I n 1998, statins accounted for 95% of the total LLD consumption. The inciden ce increased markedly around the time of the publication of the Scandinavia n Simvastatin Survival Study (4S). Only 3% of the statins were purchased wi thout reimbursement. The female/male ratio was 0.69 and the median age was 60 years. General practitioners issued 73% of the total number of LLD presc riptions, and 55% of the treatments were initiated in general practice. A l arger fraction of females and elderly started treatment in general practice . About 40% of the treatments were hospital initiated, and about one-third were followed up in general practice within the first year. Conclusions: Over the 6 years studied, utilisation of LLDs approached a lev el that may correspond to the current guideline recommendations. Compliance with guidelines should, however, be studied by following people with coron ary heart disease.