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news.A new study from Stanford University School of Medicine has revealed that doctors are under utilizing statins as treatments for heart disease. The investigation suggests that the cholesterol-lowering drugs are not being used enough in the categories of patients who would benefit most.
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The use of cholesterol-lowering drugs known as statins to reduce the risk of heart disease has exploded in recent years, but the new Stanford study shows that doctors are prescribing them in only half of their visits with patients who would benefit most from them.
Based on the findings, the researchers say physicians should be more aggressive in investigating statin therapy for patients with a high or moderate risk of heart disease, and that patients should ask to have their cholesterol levels checked regularly.
“You have to look at drug therapy on a case-by-case basis. We have many situations where drugs are misused or overused,” said lead author Dr Jun Ma, research associate at the Stanford Prevention Research Center. “In this particular case, although we did observe some inappropriate use of statins in low-risk patients, the predominant problem appears to be under use in higher risk patients.”
Although previous studies have tracked statin use on a smaller scale, Ma said this study is the first to examine how statin therapy varies according to the risk of heart disease among US outpatients.
The researchers examined two national databases that tracked outpatient visits to hospitals and physician offices between 1992 and 2002, and the types of medications that were either continued or prescribed during those visits. They then correlated the results with the number of patients who had been diagnosed with high cholesterol levels and whose risk for heart disease was categorized as either high, or low.
Among patients with high cholesterol in the moderate- and high-risk groups, the researchers found that fewer than half of the patient visits were associated with statin use in 2002. Among the high-risk group, statin use rose from 14% of patient visits in 1992 to 50% in 2002. For those at moderate risk, statin use went from 9% of patient visits in 1992 to 44% in 2002.
Ma also noted that although statin use is greatest among the high-risk group, physicians should be more aggressive in looking at statin therapy for moderate-risk patients. “Prevention is key for delaying the onset of cardiovascular disease. If we start intervention early enough, we can delay the progression of the disease and reduce the health-care costs overall,” she said.
The study was funded by an unrestricted grant from Merck Co., a pharmaceutical company that manufactures the statins Zocor and Mevacor, and by the Agency for Healthcare Research and Quality.