Pharmacists Improve Statin Prescribing Practices

A collaborative, pharmacist-led intervention targeted at health care professionals improves statin prescribing and lowers the risk of atherosclerotic events in patients with cardiovascular disease (CVD), according to research published in PLOS One.

For 12 months, researchers from the University of Glasgow in Scotland observed 31 practices with a combined total of 72 general practitioners (GPs) and 40 nurses in order to determine whether implementing a pharmacist intervention would improve statin prescribing and cholesterol target achievement in CVD patients beyond 1 year.

Over the study period, the primary care practices were assigned to either provide usual care or receive statin outreach support (SOS) delivered by 1 of 11 pharmacists with additional training on academic detailing, therapeutics, and general practice recall procedures. The purpose of the SOS intervention was to identify CVD patients who were not prescribed the right statin dose or did not reach their cholesterol targets.

Patients at the SOS practices were significantly more likely to achieve target cholesterol levels than their counterparts, which the researchers attributed to improved prescribing and dosing of simvastatin 40 mg. In fact, patients in the SOS arm had lower cholesterol levels at follow-up, “suggesting adherence to prescribing changes, despite a known tendency for nonadherence in the first year of prescribing and following dose intensification,” the authors wrote.

Practices that participated in the SOS intervention prescribed more simvastatin than general support practices, even up to 10 years later.

“Given the challenges of an aging population with multiple long-term conditions and suboptimal prescribing, health care providers require effective approaches to improve prescribing and therapeutic targets that are effective over the long term,” the authors wrote. “…SOS offers a pragmatic model for improving long-term, evidence-based statin prescribing and attainment of cholesterol targets in a high-risk population.”

The researchers said prior studies have proven that tailored, pharmacist-led interventions can predict treatment effectiveness, and important factors in a practice’s success with such interventions include collaboration, timely communication, and repeated intensive support to identify and follow-up with eligible patients. In the current study, the authors determined that “prolonged contact time and regular, repeated visits enabled pharmacists to develop working relationships with practice staff; understand individual GP, nurse, and practice’s needs; and then provide individual educational and organizational support accordingly.”