Statin initiation by GPs in WA--a structured vignette study.
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.
Stafford
Leanne
L
Curtin Health Innovation Research Institute, School of Pharmacy, Curtin University of Technology, Perth, Western Australia. l.stafford@curtin.edu.au
Harmer
Nichola
N
Dhaliwal
Satvinder
S
Jiwa
Moyez
M
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
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors