The prescribing of lipid lowering drugs during a 1-year period: analysis of 7490 health insurance files

Abstract

A study of prescription patterns by office‐based physicians was conducted to analyse the use of lipid lowering drugs (LLD) in a Germany area of 1,768,874 inhabitants during a 1‐year period. The prescription database consisted of health insurance files from a random sampling of persons (n=7490) belonging to a large statutory health insurance organization during 1993–1994. During the study period LLD were prescribed to about 2.8% of the study population. Fibrates (43.7%) were the most frequently prescribed drugs followed by HMG‐CoA reductase inhibitors (29.5%) and nicotinic acid with derivatives (21.7%). The prevalence of treatment rose with increasing age peaking among 60‐ to 69‐year‐olds (7.5%). More than two‐thirds of the patients were not treated continuously, receiving LLD for less than 6 months. Thus, in patients being treated with LLD, the therapy seems to be ineffective due to the short episodes of drug administration. The presence of hyperlipidaemia plus additional risk factors such as hypertension led to a higher rate of LLD prescriptions than that for hyperlipidaemia alone. Only half of the patients with a history of previous myocardial infarction and hyperlipidaemia received LLD. Furthermore, patients with hyperlipidaemia and additional risk factors such as arterial hypertension, diabetes mellitus and coronary heart disease (CHD), in whom administration of LLD has often been shown to be effective, were by far too infrequently treated with these drugs. Copyright © 2000 John Wiley & Sons, Ltd.

The influence of guidelines on the use of statins: analysis of prescribing trends 1998–2002

“…This finding suggests that prescribers were aware of the need to prescribe an adequate dose in order to achieve the desired effect. However, this dosage is still much less than the 40 mg dose used in the pivotal studies [22, 27], a problem that has been shown in other studies [6]. This may reflect physician concern about potential dose‐related toxicity with statin use [28, 29].…”

“…Their beneficial effects in the primary and secondary prevention of cardiovascular disease have been well documented in several large randomized controlled studies [2–4]. However, several studies have shown [5, 6] that prescription of statins lags behind the trial results, resulting in inadequate protection for those patients who would benefit from such therapy. A previous study undertaken at primary care level [7] in Ireland examined the prescribing patterns of statins over a 4‐year period (1994–8) and noted that, while statin prescribing increased during that period, usage was not directed at the population likely to benefit the most from statin therapy.…”

Prevalence of and Factors Associated With the Prescription of Fibrates Among Patients Receiving Lipid-Lowering Drugs in Germany

“…18 A 2000 study of 7011 insured individuals living in Germany found that 2.8% of them were treated with lipid-lowering drugs and that fibrates were more frequently used than statins (43.7% vs. 29.5% of prescriptions, respectively). 19 In addition, a 2008 cross-sectional study including 79,620 diabetes-related outpatient visits in Taiwan found that fibrates were the most commonly prescribed lipid-lowering drugs (29.8%-73.0%). 11 Nonetheless, a more recent French study of 31,652 people with diabetes treated with lipid-lowering drugs indicated that only 12.8% of participants were given fibrates.…”

Arzneimittelanwendung bei Alten- und Pflegeheimbewohnern im Vergleich zu Patienten in ambulanter Pflege bzw. ohne Pflegebedarf

“…Nicht-Benzodiazepin-Hypnotika mit weitaus geringerem Sucht-(11) bzw. Sturzpotenzial werden relativ zurückhaltend eingesetzt.Die Indikation zur Therapie mit Lipidsenkern sollte kritisch geprüft werden(12), gerade auch im Hinblick darauf, dass in der Cardiovascular Health Studie auch bei alten Patienten mit Hypercholesterinämie durch eine Therapie mit Statinen das kardiovaskuläre Risiko gesenkt werden konnte(14). Darüber hinaus findet sich ein hoher Anteil von alten Patienten mit einer Therapie mit Schleifendiuretika, wobei Heimbewohner häufiger mit diesen Medikamenten behandelt werden als ambulante Patienten.…”