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Impact of high dose statin trials on hospital prescribers

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Background

The PROVE-IT and REVERSAL studies established that an intensive 80 mg/day dose of atorvastatin was superior to pravastatin 40 mg/day for the secondary prevention of coronary heart disease (CHD) following acute coronary syndromes and in limiting the progression of coronary atherosclerosis. We have evaluated the impact of the results from these studies on statin prescribing by hospital doctors in the 2 years following their publication.

Methods and results

Using a nationwide database, 18,894 patients receiving a total of 23,750 hospital discharge prescriptions for atorvastatin were identified between September 2002 and December 2005. From this cohort, patients newly commenced on, switched to, or dose titrated on atorvastatin by a hospital prescriber were identified. The mean daily atorvastatin dose on discharge was calculated for each month and the results were analysed using a segmented regression analysis. There was a significant and sustained increase in the mean atorvastatin dose used by hospital prescribers. This resulted in an increase of 12 mg, (95% CI 10.6, 13.4) in the mean dose prescribed by December 2005. This was attributable largely to a 16.4% (95% CI 13.5, 19.3), 17.2% (95% CI 14.0, 20.5) and 8.8% (95% CI 7.4, 10.2) increase in the prescribing of the 20 mg, 40 mg and 80 mg/day dosages, respectively.

Conclusion

The PROVE-IT and REVERSAL studies have had a significant impact on hospital prescribers’ choice of atorvastatin dose. It is likely that this has been the result of both the publication and effective promotion of results from these trials.

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Acknowledgements

We would like to thank the Irish HSE primary care reimbursement services for supplying the data on which the study was based.

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Authors and Affiliations

  1. Department of Pharmacology and Therapeutics, Trinity College Dublin, St Jame’s Hospital, Dublin 8, Ireland

    Thomas I. Barron, Kathleen Bennett & John Feely

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  1. Thomas I. Barron
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  2. Kathleen Bennett
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  3. John Feely
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Correspondence to Thomas I. Barron.

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Barron, T.I., Bennett, K. & Feely, J. Impact of high dose statin trials on hospital prescribers. Eur J Clin Pharmacol 63, 65–72 (2007). https://doi.org/10.1007/s00228-006-0208-x

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  • DOI: https://doi.org/10.1007/s00228-006-0208-x

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