Abstract
Objectives: To evaluate antihyperlipidaemic drug use in the Bologna region of Italy in relation to gender and age, and to define the patterns of prescription, establish the extent to which drug therapy was continuous, and to investigate self-reported patient compliance with dietary regimens.
Patients and Methods: A questionnaire was administered over a period of 19 days to all individuals purchasing an antihyperlipidaemic drug in a public or private pharmacy. The study included 1999 individuals (1150 females and 844 males; gender was not reported in five cases) with a mean age of 63.68 ± 10.40 years.
Results: Males commenced treatment at a mean age of 57.64 years, and females at a mean age of 62.0 years. The mean treatment duration was 42.82 months in males and 43.46 months in females. Therapy was proposed by general practitioners in 64.2% of patients, by hospital specialists in 28.4%, and by specialists working in private clinics or medical centres in 6.4% (1% of patients asked spontaneously to begin antihyperlipidaemic treatment). A total of 72.4% of patients reported using statins, 22.7% fibrates, 2.8% resins and 2.3% other drugs. Simvastatin was the most frequently prescribed statin (51.0%), followed by pravastatin (16.5%). The most prescribed fibrate was gemfibrozil (13.2%). Males and females used the same drugs except for gemfibrozil, which was more commonly used in males, and pravastatin, which was more frequently used in females. The prescribed daily dose of statins was very close to the defined daily dose, showing a strict adherence to the currently available drug-prescribing recommendations.
Conclusion: This study provided a useful means of investigating the applications of guidelines, particularly with regard to antihyperlipidaemic drug use in coronary heart disease prevention.
Similar content being viewed by others
References
Smith SC Jr, Greenland P, Grundy SM. AHA Conference Proceedings. Prevention conference V: Beyond secondary prevention: identifying the high-risk patient for primary prevention: executive summary. American Heart Association. Circulation 2000; 101: 111–6
Sans S, Kesteloot H, Kromhout D, on behalf of the Taskforce. The burden of cardiovascular diseases mortality in Europe. Task Force of the European Society of Cardiology on cardiovascular mortality and morbidity statistic in Europe. Eur Heart J 1997; 18: 1231–48
Brown V. Impact of dyslipidaemia. Pharmacoeconomics 1998; 14(3): 1–9
Gordon T, Kannel WB, Castelli WP, et al. Lipoproteins, cardiovascular disease and death: the Framingham Study. Arch Intern Med 1981; 141: 1128–31
Castelli WP, Garrison RJ, Wilson PWF, et al. Incidence of coronary heart disease and lipoprotein cholesterol levels: the Framingham Study. JAMA 1986; 256: 2835–8
Stamler J, Wentwort D, Neaton JD. Is the relationship between serum cholesterol and risk of premature death continuous and graded? Findings in 356222 primary screens of the Multiple Risk Factor Intervention Trial (MRFIT). JAMA 1986; 256: 2823–8
Kromhout D. On the waves of the Seven Countries Study: a public health perspective on cholesterol. Eur Heart J 1999; 20: 796–802
West of Scotland Coronary Prevention Study Group. Baseline risk factors and their association with outcome in the West of Scotland Coronary Prevention Study. Am J Cardiol 1997; 79(6): 756–62
Scandinavian Simvastatin Survival Study Group. Randomized trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet 1994; 344: 1383–9
Frick MH, Elo MO, Haapa K, et al. Helsinki Heart Study: primary prevention trial with gemfibrozil in middle aged men with dyslipidaemia. Safety of treatment, changes in risk factors and incidence of coronary heart disease. N Engl J Med 1987; 317: 1237–45
Lipid Research Clinics Program. The Lipid Research Clinics Coronary Primary Prevention Trial results. I. The relationship of reduction in incidence of coronary heart disease. JAMA 1984; 251: 351–64
Lipid Research Clinics Program. The Lipid Research Clinics Coronary Primary Prevention Trial results. II. The relationship of reduction in incidence of coronary heart disease to cholesterol lowering. JAMA 1984; 251: 365–74
Coronary Drug Project Research Group. Clofibrate and niacin in coronary heart disease. JAMA 1975; 231: 360–81
Canner P, Berge K, Wengwe NK, et al. Fifteen year mortality in coronary drug project patients: long term benefit with niacin. J Am Coll Cardiol 1986; 8: 1245–55
The International Task Force for Prevention of Coronary Heart Disease. Coronary heart disease: reducing the risk. The scientific background for primary and secondary prevention of coronary heart disease — a worldwide review. Nutr Metab Cardiovasc Dis 1998; 8: 205–71
Tognoni G, Laporte JR. From clinical trials to drug utilisation studies in MNG Dukes editor drug utilization studies: methods and uses. WHO regional publications, European Series 1994; 45: 23–41
Deabajo FJ, Madurga M, Montero D, et al. Trends in the supply and use of lipid-lowering drugs in Spain, 1983 through 1991. Therapie 1993; 48(2): 145–49
Boumendil EF. Descriptive study of lipid-modulating drug use in French professional population. J Clin Epidemiol 1994; 47(10): 1163–71
Treuter I, Kotze TJV. A drug utilisation study investigating prescribed daily doses of hypolidaemic agents. S Afr Med J 1996; 86(11): 1397–401
Martikainen J, Klukka T, Reunanen A, et al. Recent trends in the consumption of lipid-lowering drugs in Finland. J Clin Epidemiol 1996; 49(12): 1453–7
Yang YHK, Kao SM, Chan KWA. A retrospective drug utilisation evaluation of antihyperlipidaemic agents in a medical centre in Taiwan. J Clin Pharm Ther 1997; 22(4): 291–9
Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering in 4444 patients with coronary artery disease: the Scandinavian Simvastatin Survival Study. Lancet 1994; 344: 1383–9
Woond D. European and American recommendations for coronary heart disease prevention. Eur Heart J 1998; 19S: A12–A19
Nielsen PE. The medical products agency’s new guidelines on complement to medical treatment of hypercholesterolemia. Ugeskr Laeger 1998; 160: 4665–7
Shepherd J. Prevention of coronary heart disease in clinical practice: a commentary on current treatment patterns in six European countries in relation to published recommendations. Cardiology 1996; 87: 1–5
National Cholesterol Education Program Export Panel. Second report of the Expert Panel on Detection, Evaluation and treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II). Circulation 1994; 89: 1329–445
Garber AM, Browner WS. Cholesterol screening guidelines. Consensus, evidence and common sense. Circulation 1997; 95(6): 1642–5
Jones AF. Statins and hypercholesterolemia: UK Standing Medical Advisory Committee guidelines. Lancet 1997; 350: 1174–5
Wood D, De Backer G, Faergeman O, et al., and members of the Task Force. Prevention of Coronary Heart Disease in Clinical Practice. Summary of Recommendations of the Second Joint Task Force of European and other Societies on Coronary Prevention 1998. J Hypertens 1998; 16: 1407–14
Acknowledgements
The authors wish to acknowledge the support of Prof. G. Cantelli Forti, Dean of the Pharmacy Faculty, University of Bologna, Bologna, Italy; the Ordine dei Farmacisti della Provincia di Bologna, Bologna, Italy; Federfarma, Bologna, Italy; and the help of all professionals in the public and private pharmacies in Bologna who actively collected the data upon which this paper was based. This study was funded by the pharmacists’ associations of Bologna.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Gaddi, A., Berto, P., Mussoni, C. et al. Antihyperlipidaemic Drugs. Clin. Drug Investig. 19, 457–464 (2000). https://doi.org/10.2165/00044011-200019060-00008
Published:
Issue Date:
DOI: https://doi.org/10.2165/00044011-200019060-00008