Estimación del riesgo coronario en España mediante la función de Framingham calibrada
- J Marrugat, P Solanas, R D’ Agostino, L Sullivan, J Ordovas, F Cordón
- Rev Esp Cardiol
BACKGROUND The efficacy of statins to reduce LDL-cholesterol serum levels is high, but effectiveness is limited and costs are elevated. OBJECTIVE The efficiency and effectiveness of prescriptions were analyzed in a pilot study in a community pharmacy. DESIGN A cross-sectional study. LOCATION Community pharmacy. Prescriptions from two Murcian Health Service Centers in Lorca, Murcia (Spain). PARTICIPANTS A total of 141 patients and 32 general practitioners were included. The efficiency was analyzed in 141 and effectiveness in 110 patients. MAIN MEASUREMENTS Socio-demographic characteristics and clinical history of patients and information about statin type and dosage were collected. Each patient was analyzed to determine the effectiveness of treatment according to cardiovascular risk and previous LDL-cholesterol level, and efficiency comparing the statin prescribed against other statins with equal pharmacological power. RESULTS The most prescribed statin was atorvastatin (57.4%). Almost two-thirds (63.9%) of prescriptions were inefficient, and 17.3% were ineffective. In a bivariate analysis, patients with previous cardiovascular events (8/38; 21% vs 41/103; 39.8%. P=.040) and smokers (42/114; 36.8% vs 4/23; 17.4%, P=.047) were more likely to receive an inefficient prescription than patients with no cardiovascular events and non-smokers. In a multivariate analysis, smokers were more likely to receive an inefficient prescription than non-smokers (OR ajusted 3.76; 95% CI;1.03-0.77, P=.012). CONCLUSIONS Most of the participants reached therapeutic objectives for LDL-Cholesterol levels, but more than half of the prescriptions were considered inefficient.