Friday, July 18, 2014

GPs warn of chaos over bid to offer statins to 17m to prevent heart disease: Doctors being told to trawl medical records to find at-risk patients

  • Statins could be offered to half of all adults in UK under new guidelines
  •  Doctors asked to check patient records for those at risk of side effects
  • Check ups will then be scheduled, potentially causing backlogs at surgeries 




  • Almost half of all adults could be offered statins under new guidelines from the health watchdog.
    NICE is advising GPs to consider prescribing the pills to up to 17million patients to prevent heart disease.
    Family doctors are being urged to trawl medical records to find patients at risk who will then be invited in for check-ups.
    Family doctors are being asked to trawl through the medical records of patients to find those at risk from the side-affects of statins, then book check-up appointments which they warn could over-burden surgeries
    Family doctors are being asked to trawl through the medical records of patients to find those at risk from the side-affects of statins, then book check-up appointments which they warn could over-burden surgeries
    However, GPs say that already overstretched surgeries will be deluged with patients booking the check-ups, leading to even longer waiting times for appointments.
    Other doctors warn that the population faces being ‘medicalised’ when too little is known about the potential side-effects.
    The known side-effects include type 2 diabetes and severe muscular pain and there is also evidence that patients regard the pills as an excuse to lead unhealthy lifestyles.
    Guidelines issued by NICE today tell GPs to consider prescribing statins to anyone with a 10 per cent risk of developing heart disease within a decade (generally people over the age of 40). Currently, they are offered to patients with a 20 per cent risk.
    NICE estimates that between five and ten million adults are currently taking the drugs, although 12.5million are eligible.
    But under the new guidelines, another 4.5million would qualify.
    This means that 17million adults – nearly half of the 37million adults in Britain – would either be on statins or offered them.
    NICE estimates that it would cost the NHS an extra £52million to prescribe statins to the 4.5million adults newly eligible. Experts say if all eligible patients took statins, 510,000 heart attacks or strokes could be prevented a year. 
    Professor Mark Baker, director of the Centre for Clinical Practice at NICE, said: ‘Statins are safe and effective and now they are cheaper it is a good deal for more people to have access to them under the NHS.
    ‘The overwhelming body of evidence supports their use, even in people at low risk of cardiovascular disease. The effectiveness of these medicines is now well proven and their cost has fallen.
    ‘It is ludicrous to suggest that we are over-medicalising the population when the whole point of using modern, safe and effective drugs in an economic way is to prevent bad things happening in the future.’ 
    However, Dr Chaand Nagpaul, chair of the British Medical Association’s GP committee, said: ‘In making their decision NICE have failed to take the current pressures on general practice into account, and the further impact this will have on already overstretched GPs and those patients requiring treatment for other illnesses.’
    Other experts say there is no evidence the drugs prevent heart attacks or strokes in healthy patients who don’t have heart disease. 
    Dr Kailash Chand, a GP and deputy chair of the British Medical Association who stopped taking statins after developing crippling muscle pain, said: ‘These guidelines mean you are medicalising millions of the population without any evidence.
    ‘Statins have an important role for patients who already have heart disease. But for healthy patients, the benefits are very, very minimal. 
    'When people have side effects and they need follow-up investigations and scans they are going to take up a lot of time and NHS resources.’
    Dr Aseem Malhotra, a cardiologist who also runs the Academy of Royal Medical Colleges, said: ‘A mass prescription to millions of healthy people will not benefit population health and will contribute to excess costs. 
    'Low-risk patients must be told statins will not reduce their risk of death. What I see with my own patients is they think they have got the magic pill, which is an excuse to gorge on junk food.’
    Last month it emerged that six of the 12-strong panel of experts drawing up the NICE guidelines had financial links to drugs firms making statins, or similar pills.
    At the time a group of leading doctors wrote to NICE and the Health Secretary Jeremy Hunt urging them to rethink the proposed guidelines.
     


    Read more: http://www.dailymail.co.uk/health/article-2696691/GPs-warn-chaos-bid-offer-statins-17m-prevent-heart-disease-Doctors-told-trawl-medical-records-risk-patients.html#ixzz37q79jFEy 
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