Clinical factors associated with inappropriate prescription of statins

BACKGROUND AND OBJECTIVE: The aim of this study was to determine the percentage of subjects receiving statin treatment that was inappropriate and to evaluate the associated clinical factors. PATIENTS AND METHOD: A cross-sectional multi-centred study conducted across the Autonomous Regions of Spain. The appropriateness of prescription was based on the guidelines of the. National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) and the European Guidelines on Cardiovascular Disease Prevention. RESULTS: Of the 1,817 patients studied, 52.9% were male, the overall mean age was 59.4 years, 36% had cardiovascular disease and 32.7% had diabetes. In 90.8% of the population the prescription was correct according to at least one of the two guides being used, with a low concordance between them (kappa = 0.279). Almost 100% of subjects with cardiovascular disease or diabetes had an appropriate prescription. In primary prevention, 82.7% had an appropriate prescription according to at least one of the two guides used, but this percentage decreased to 20.7% when based on the European Guidelines. In multivariate analysis, there was agreement with both guides. The inappropriate prescription was directly, and significantly, associated with primary prevention and female gender, while being inversely related to age, smoking habit and LDL-cholesterol concentration. CONCLUSIONS: Most of the patients receiving statin treatment have an appropriate prescription, but the percentage of inappropriate prescription increases significantly in patients in primary prevention following European Guidelines.