Initiation rates of statin therapy for the primary prevention of cardiovascular disease: an assessment of differences between countries of the UK and between regions within England.
OBJECTIVE
To investigate the extent to which variation exists in the initiation rate of statin therapy for the primary prevention of cardiovascular disease between countries of the UK and between different regions within England.


METHODS
Cohort study using data from a large UK primary care database.


METHODS
4,820,885 individuals from 554 general practices during the period 2004-2012.


METHODS
Rate of statin therapy initiation per 1000 person-years.


RESULTS
Relative to a fixed English rate of 1 initiation per 1000 person-years and accounting for gender, age and social deprivation level, the rate was similar for Scotland at 0.92 (95% CI 0.84 to 1.00) and rates for Northern Ireland and Wales were higher at 1.40 (95% CI 1.20 to 1.62) and 1.18 (95% CI 1.05 to 1.32), respectively. Within England, the regions could be classified into three groups with respect to statin therapy initiation rates (relative to a rate of 1 initiation per 1000 person-years for London): the South Central 0.73 (95% CI 0.64 to 0.83), South West 0.80 (95% CI 0.71 to 0.91), East of England 0.81 (95% CI 0.71 to 0.94) and South East Coast 0.83 (95% CI 0.73 to 0.95); strategic health authorities had similar low rates followed by the East Midlands 0.88 (95% CI 0.73 to 1.05), West Midlands 0.96 (95% CI 0.84 to 1.09), North East 0.96 (95% CI 0.79 to 1.16), Yorkshire and Humber 0.97 (95% CI 0.81 to 1.17) and London strategic health authorities. North West England exhibited the highest rate of statin therapy initiation of 1.16 (95% CI 1.02 to 1.31).


CONCLUSIONS
Considerable variation in the rate of statin therapy initiation was observed between the four countries of the UK and between different geographical regions within England.
Department of Statistical Science, University College London, London, UK.
Aidan G
AG
O'Keeffe
Department of Primary Care and Population Health, University College London, London, UK.
Irene
I
Petersen
Department of Primary Care and Population Health, University College London, London, UK.
Irwin
I
Nazareth
D000328:Adult; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004739:England; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D009660:Northern Ireland; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011322:Primary Prevention / Q000706:statistics & numerical data*; D012606:Scotland; D014852:Wales
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
CARDIOLOGY; PREVENTIVE MEDICINE; PRIMARY CARE