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Lifestyle or Life-Saving Medicines? A Primary Healthcare Professional and Consumer Opinion Survey on Over-the-Counter Statins

Medical Student, School of Medicine, University of Birmingham, Birmingham, England

Melpomeni Kountouri, BMedSc

Medical Student, School of Medicine, University of Birmingham

Tom Marshall, MSc

Clinical Senior Lecturer, Department of Public Health and Epidemiology, School of Medicine, University of Birmingham

Sheila M Greenfield, PhD

Senior Lecturer, Department of Primary Care and General Practice, School of Medicine, University of Birmingham

Reprints: Dr. Greenfield, Department of Primary Care and General Practice, University of Birmingham, Birmingham B15 2TT, UK, fax 0121 414 7938, S.M.Greenfield{at}bham.ac.uk

BACKGROUND: Over-the-counter (OTC) simvastatin 10 mg became available in the UK in July 2004 with the aim of improving primary prevention of ischemic heart disease.

OBJECTIVE: To document the views of the main stakeholders (general practitioners [GPs], community pharmacists, and consumers) on issues pertaining to the reclassification of simvastatin to OTC availability, highlight differences between stakeholder groups, and identify factors likely to influence consumer behavior.

METHODS: A self-administered questionnaire survey of GPs, community pharmacists, and potentially eligible consumers was carried out 8 months after the UK launch of OTC simvastatin. Participants were asked about their awareness of the drug, their willingness to use such medicines, and their views on relevant management practices.

RESULTS: Awareness of OTC simvastatin was high among GPs but limited among consumers. Although OTC availability was favored by pharmacists, consumers and GPs generally thought it was not a good idea. GPs and pharmacists cited increased consumer choice as the most important likely benefit; consumers thought potential savings to the National Health Service were equally important. Medication misuse and neglect of lifestyle risk factors were unanimously considered to be the most important likely risks. Unlike the majority of pharmacists, most GPs thought that current dosing guidelines were inappropriate, but there was consensus that long-term nonadherence would probably curtail any treatment benefit. Most respondents agreed that GPs should be informed if their patients were using OTC statins but disagreed as to the best way to communicate this information.

CONCLUSIONS: OTC availability of statins did not appear to be considered a popular public health intervention by consumers and GPs, as the drugs were widely perceived as being prone to misuse. However, OTC availability was favored by pharmacists, who saw this as empowering both for consumers and themselves. Key issues in dispensing, managing, and evaluating the public health impact of this intervention remain outstanding.

Key Words: healthcare professional, over-the counter statins, patient views

Published Online, February 26, 2008. www.theannals.com, DOI 10.1345/aph.1K421