title: Statin initiation by GPs in WA--a structured vignette study.
abstract: BACKGROUND
  Statins are recommended for all patients with known coronary heart disease. This pilot study investigated statin initiation by a Western Australian general practitioner cohort and the influence of prescriber and patient characteristics on prescribing.
  
  
  METHODS
  A structured vignette questionnaire was posted to members of the Fremantle GP Network. Respondents indicated their prescribing decisions for nine hypothetical patients who had recently suffered a myocardial infarction. Data analysis utilised logistic regression analyses and a generalised linear model with a logit link function.
  
  
  RESULTS
  Fifty-five GPs responded (16.0% response rate). In over 20% of cases a statin was not prescribed. Male (OR 4.71; 95% CI: 1.24-17.87) and GPs with fewer years in practice (4.50; 1.21-16.77) were more likely to prescribe appropriately. Younger patients (2.21; 1.38-3.53), and those with diabetes (1.74; 1.09-2.76) or hypercholesterolaemia (4.81; 2.88-8.03) were more likely to receive therapy.
  
  
  CONCLUSIONS
  Prescribing practices failed to comply with current guidelines in a significant number of cases. Further research to confirm these findings is warranted.
authors.affiliation: Curtin Health Innovation Research Institute, School of Pharmacy, Curtin University of Technology, Perth, Western Australia. l.stafford@curtin.edu.au
authors.forename: Leanne
authors.initials: L
authors.lastname: Stafford
authors.forename: Nichola
authors.initials: N
authors.lastname: Harmer
authors.forename: Satvinder
authors.initials: S
authors.lastname: Dhaliwal
authors.forename: Moyez
authors.initials: M
authors.lastname: Jiwa
mesh_terms: D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D010821:Physicians, Family; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014904:Western Australia
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors