Be prepared for lower threshold for statin treatment, urges expert
Clinical Nice proposal could lead to more patients seeking information about benefits and risks, a CVD consultant pharmacist has warned
Pharmacists need to ensure they are "fully equipped" to help patients make informed decisions about taking statins if a proposal to halve the threshold for starting the preventative treatment is agreed, an expert has said.
Nice's draft guideline to start patients on statin treatment if they have a 10 per cent risk of developing cardiovascular disease (CVD) within 10 years rather than a previous 20 per cent risk could "significantly reduce" heart attacks and strokes across the UK population, said CVD consultant pharmacist Helen Williams.
However, pharmacists needed to be prepared to initiate more conversations about the benefits and risks associated with the treatment and ensure patients knew they were available to discuss side effects, Ms Williams, who works at the South London Cardiac and Stroke Network, told C+D on this week (February 17).
Pharmacists should quantify the risks of statin side effects to reassure patients |
More on Nice guidance Nice u-turn on paracetamol advice in osteoarthritis Nice issues final approval of omalizumab for severe asthma Nice recommends asthma drug Xolair in u-turn on cost-effectiveness |
Nice was proposing the update to its 2008 guidelines to reflect changes in price and availability of generic statins, it announced last week (February 12) and was recommending atorvastatin 20mg for those starting their statin treatment. |
Ms Williams said pharmacists would need to help "discard" some of the "myths" reported in the mainstream press about the risks of statins. Pharmacists should quantify risks to ensure patients understood that a rare side effect may occur in one in 10,000 people and a common side effect in only one in 100 people, she said.
"The emphasis in the media is how bad these things are that we're trying to push on people and not really putting into context that many people take them without a problem," she said.
"We need to have that discussion [with] an individual so they understand if they have problems we're here to resolve those issues. We're not saying you have to have this drug at this dose and that's it, but there are options for people," she added.
MURs provided a "big chance" for pharmacists to discuss the "sustained" benefit of preventative treatment and for clarifying the difference between medicines taken for symptoms and those for "amending" risk, she said.
Mike Hewitson, owner of Beaminster Pharmacy, Dorset, agreed that a new threshold would mean additional work for pharmacists as it would lead to more conversations with patients.
"[Statins] get preyed on a lot by the mainstream press and generally worry people. So we spend a lot of time talking to people already about how [they] should use this medicine," he said. However, the drugs would help reduce the long-term health burden, he said.
A consultation on the draft guidelines is running until March 26.
Are you confident in your ability to advise patients on the side effects of statins? Comment below or email us at [email protected] You can also find C+D on Twitter, LinkedIn and Facebook |