Projects per year
Abstract
BACKGROUND: Initiation of statins for the primary prevention of cardiovascular disease (CVD) should be based on CVD risk estimates, but their use is suboptimal.
AIM: To investigate the factors influencing statin prescribing when clinicians code and do not code estimated CVD risk (QRISK2).
DESIGN AND SETTING: A historical cohort of patients who had lipid tests in a database (IQVIA Medical Research Data) of UK primary care records.
METHOD: The cohort comprised 686 560 entries (lipid test results) between 2012 and 2016 from 383 416 statin-naive patients without previous CVD. Coded QRISK2 scores were extracted, with variables used in calculating QRISK2 and factors that might influence statin prescribing. If a QRISK2 score was not coded, it was calculated post hoc. The outcome was initiation of a statin within 60 days of the lipid test result.
RESULTS: Of the entries, 146 693 (21.4%) had a coded QRISK2 score. Statins were initiated in 6.6% (95% confidence interval [CI] = 6.4% to 6.7%) of those with coded and 4.1% (95% CI = 4.0% to 4.1%) of uncoded QRISK2 ( P<0.001). Statin initiations were consistent with National Institute for Health and Care Excellence guideline recommendations in 85.0% (95% CI = 84.2% to 85.8%) of coded and 44.2% (95% CI = 43.5% to 44.9%) of uncoded QRISK2 groups ( P<0.001). When coded, QRISK2 score was the main predictor of statin initiation, but total cholesterol was the main predictor when a QRISK2 score was not coded.
CONCLUSION: When a QRISK2 score is coded, prescribing is more consistent with guidelines. With no QRISK2 score, prescribing is mainly based on total cholesterol. Using QRISK2 is associated with statin prescribing that is more likely to benefit patients. Promoting the routine CVD risk estimation is essential to optimise decision making.
Original language | English |
---|---|
Pages (from-to) | E219-E225 |
Journal | British Journal of General Practice |
Volume | 71 |
Issue number | 704 |
Early online date | 25 Feb 2021 |
DOIs | |
Publication status | Published - Mar 2021 |
Bibliographical note
© The Authors.Keywords
- cardiovascular diseases
- cholesterol
- decision making
- shared
- general practice
- Hydroxymethylglutaryl-CoA reductase inhibitors
- risk assessment
Fingerprint
Dive into the research topics of 'Factors predicting statin prescribing for primary prevention: A historical cohort study'. Together they form a unique fingerprint.Projects
- 1 Finished
-
Ensuring test evaluation research is applicable in practice: investigating the effects of routine data on the validity of test accuracy meta-analyses
Willis, B. (Principal Investigator)
1/09/16 → 31/08/21
Project: Research Councils
Equipment
-
Birmingham Environment for Academic Research (BEAR)
Facility/equipment: Equipment