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Statin Prescription by Croatian Family Doctors – Lack of Systematic Proactive Approach to Cardiovascular Disease Prevention

Abstract

The aim of this study was to investigate statin prescription by family doctors (GP) in primary (PP) and secondary (SP) prevention of cardiovascular diseases (CVDs). Patients’ socio-demographic data, total cholesterol (TC) and LDL-cholesterol (LDL-C) thresholds for statin prescription, indications, data on GP and practices were registred. Statins were prescribed in 11.2% enlisted patients (64.11% PP, 35.88% SP), mostly aged 70+. In PP, thresholds were TC 6.2±1.09 mmol/L, LDL-C 3.6 mmol/L, in SP 5.4±1.26 mmol/L, 2,7mmol/L, respectively. Most frequently prescribed statin in PP was 10 mg atorvastatin (49.28%), in SP it was 20 mg simvastatin (48.36%). Participating GPs were women, aged 39±5.49, working for 13±6 years, the average number of enlisted patients per GP 1562±299. There was statisticaly significant difference in statin prescription in PP (c2=752.9; p<0.001) and SP (c2=64; p<0.001). Statin prescription in PP is due to pharmaceutical marketing and lack of independent continuing medical education. The fact that statins are most frequently prescribed in patients aged 70+ (35.28% in PP, 49.35% SP) reveals lack of preventive proactive CVDs approach in younger age groups, which is concerning

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