BJGP Open最新文献

{"title":"Low-density lipoprotein cholesterol levels and treatment intensity in secondary prevention of patients with ischaemic heart disease in the primary care setting: a real-world data registry study.","authors":"Núria Sánchez-Ruano, Anna Fibla-Matamoros, Carles Falces, Encarna Sánchez, Antoni Sisó-Almirall, Luis González-de Paz","doi":"10.3399/BJGPO.2024.0220","DOIUrl":"10.3399/BJGPO.2024.0220","url":null,"abstract":"<p><strong>Background: </strong>Monitoring low-density lipoprotein cholesterol (LDL-C) and prescribing appropriate treatment is crucial for secondary prevention in primary care.</p><p><strong>Aim: </strong>To study LDL-C levels and treatments for patients with ischaemic heart disease according to target recommendations and assess factors influencing prescribed drug intensity.</p><p><strong>Design & setting: </strong>A cross-sectional study was undertaken. We examined electronic health records of patients with ischaemic heart disease from three primary care centres in Spain.</p><p><strong>Method: </strong>LDL-C levels were assessed using the most recent registry, and LDL-C-lowering treatments were categorised by their theoretical efficacy. Factors associated with LDL-C target attainment were analysed using univariate and multivariate regression models. Prescription intensity was studied with ordinal logistic regression models.</p><p><strong>Results: </strong>We studied 1936 patients, 14.88% of whom received no LDL-C-lowering treatment. The percentages of patients who achieved LDL-C thresholds of<70 mg/dl and<55 mg/dl were 35.0% and 12.65%, respectively. The factor associated with the <55 mg/dl threshold was type 2 diabetes mellitus (odds ratio [OR] 0.55, 95% confidence interval [CI] = 0.42 to 0.73), with males showing better LDL-C levels (OR 0.34, 95% CI = 0.23 to 0.51). Males had higher-intensity prescriptions (OR 1.57, 95% CI = 1.27 to 1.94) and older patients had lower-intensity treatments (OR 0.96, 95% CI = 0.95 to 0.97).</p><p><strong>Conclusion: </strong>Increased LDL-C drug treatment improvement, monitoring, and adherence to guideline recommendations are necessary for patients with ischaemic heart disease. Sex and age are potential factors associated with inadequate lipid-lowering treatment intensity and poor LDL-C control that might worsen cardiovascular outcomes in high-risk patients, leading to avoidable inequity among patients who visit the primary health setting.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prescribing of opioids for chronic non-cancer pain in the menopausal and postmenopausal population: a drug utilisation study in the UK.","authors":"Emma Tillyer, Yogini Jani, Li Wei, Ruth Brauer","doi":"10.3399/BJGPO.2024.0169","DOIUrl":"10.3399/BJGPO.2024.0169","url":null,"abstract":"<p><strong>Background: </strong>Opioid use for chronic non-cancer pain (CNCP) is consistently higher in menopausal and postmenopausal women than in younger women or men, elevating their risk of opioid-related adverse health outcomes. Since pain severity increases with hormonal changes accompanying menopause, these women should be a focus of opioid stewardship efforts.</p><p><strong>Aim: </strong>To examine opioid prescribing trends for CNCP in menopausal and postmenopausal women diagnosed with a musculoskeletal condition.</p><p><strong>Design & setting: </strong>Population-based drug utilisation study, which was undertaken with data from IQVIA Medical Research Data UK.</p><p><strong>Method: </strong>Annual opioid prescribing incidence, prevalence, and average duration of use were calculated for a cohort of women aged 50-79 years with musculoskeletal conditions newly diagnosed between 2010 and 2021. Specific results were stratified by age, pain indication, and Townsend score.</p><p><strong>Results: </strong>From 2010-2021, incident prescribing rates of opioids increased in women aged 50-54 years (161.4 [95% confidence interval {CI} = 149.7 to 174.0] per 1000 person-years at risk [PYAR] in 2010 to 239.6 [95% CI = 211.7 to 271.2] per 1000 PYAR in 2021); these women discontinued opioid use faster (<1 year) than older age groups (~2 years). Overall, opioid prescribing prevalence decreased from 23% in 2010 to 14% in 2021, and average opioid use duration decreased from 3 years to 1 year (2010-post-2017) in women aged 50-79 years.</p><p><strong>Conclusion: </strong>The overall observed decrease in prevalence and average duration of opioid use is encouraging. Incident prescriptions are rising in women aged 50-54 years and those with fibromyalgia while remaining steady in women aged 55-79 years. Understanding the impact of menopause and post-menopause on opioid use trends is important for effective opioid stewardship.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescribing practices for proton pump inhibitors among primary care physicians in England: an evaluation.","authors":"Kate Plehhova, Joshua Wray, Patricia Aluko, Scott Sutton, Jim McArdle, Anne Dawson, Cathal Coyle, Richard M Stevens","doi":"10.3399/BJGPO.2024.0059","DOIUrl":"10.3399/BJGPO.2024.0059","url":null,"abstract":"<p><strong>Background: </strong>Proton pump inhibitors (PPIs), the most frequently prescribed drug class globally, are often overused.</p><p><strong>Aim: </strong>To assess PPI prescribing practice in England.</p><p><strong>Design & setting: </strong>Electronic medical record (EMR) evaluation from 62 primary care GP practices in England.</p><p><strong>Method: </strong>Adult patients on continuous PPI treatment (repeat prescription or ≥4 acute prescriptions 6 months before data extraction) were included (August 2021-June 2022) to compare PPI prescribing practices versus National Institute for Health and Care Excellence (gastro-oesophageal reflux disease [GORD] and dyspepsia management) and Medicines and Healthcare products Regulatory Agency (clopidogrel and PPI interaction) guidelines.</p><p><strong>Results: </strong>We identified 77 356 patients on continuous PPI treatment. The most common (68%) diagnosis recorded in patients' EMRs and indicated for PPI use was gastroprotection, although 62% had no recorded indication. Of these 62% of patients, 40% had no medication review in the preceding year. Among those with diagnoses indicated for ≤3 months of PPI therapy (34%), 99% received their first PPI prescription ≥3 months previously. Of patients with diagnoses indicated for long-term treatment (4%), 41% had no medication review in the preceding year. Furthermore, 18% of patients using omeprazole or esomeprazole were also prescribed clopidogrel, and 19% of those prescribed treatments associated with gastrointestinal risk (<i>n</i> = 14 826) were not prescribed PPIs.</p><p><strong>Conclusion: </strong>This study shows that PPI prescribing in England is not in alignment with existing clinical guidelines and highlights the need for appropriate measures to increase awareness of overuse and support deprescribing where appropriate.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare users' evaluations of general practice: a survey among Danish men aged 45-70 years.","authors":"Søren Birkeland, Sören Möller","doi":"10.3399/BJGPO.2024.0153","DOIUrl":"10.3399/BJGPO.2024.0153","url":null,"abstract":"<p><strong>Background: </strong>Knowledge about healthcare users' evaluations of general practice is relatively limited.</p><p><strong>Aim: </strong>We aimed to investigate Danish men's evaluations of general practice health care and different aspects of GPs' communication with patients.</p><p><strong>Design & setting: </strong>Secondary analyses of data from a web-based survey of 6756 Danish men aged 45-70 years.</p><p><strong>Method: </strong>We used municipality-level information from registries, self-reported sociodemographic data, personality characteristics, and 5-point Likert scale evaluations of health care and communication in general practice. Comparisons were made between groups using multivariable linear regression.</p><p><strong>Results: </strong>The response rate was 28%. A large majority of participants agreed or strongly agreed that their GP treatment had been 'almost perfect', with slightly fewer responding that their GP was good at showing consideration for them. The latter item was, however, reversed, making comparisons difficult and all differences were small. Older healthcare users evaluated health care higher than did younger healthcare users; higher scores on the extraversion, agreeableness, and conscientiousness personality dimensions generally were associated with higher evaluation scores, whereas the opposite tended to be true for responders with higher neuroticism scores. When not controlling for multiplicity, participants in rural areas tended to evaluate the explanation of medical procedures with lower scores; participants with cerebrovascular disease and those residing in higher tax income areas tended to evaluate GP care less positively in general.</p><p><strong>Conclusion: </strong>Despite an overall high evaluation of GP care, evaluations may vary, including among different groups of healthcare users.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's been tried: a curated catalogue of efforts to improve access to general practice.","authors":"Carol Sinnott, Evleen Price, Akbar Ansari, Rebecca Fisher, Jake Beech, Hugh Alderwick, Mary Dixon-Woods","doi":"10.3399/BJGPO.2024.0184","DOIUrl":"10.3399/BJGPO.2024.0184","url":null,"abstract":"<p><strong>Background: </strong>Although increasing numbers of appointments are being provided, public satisfaction with access to UK general practice is declining. Previous attempts to improve access have not been systematically collated.</p><p><strong>Aim: </strong>To identify interventions to improve access to general practice in the UK, to organise these interventions into thematic categories, and to identify which aspects of access are targeted.</p><p><strong>Design & setting: </strong>Narrative systematic review.</p><p><strong>Method: </strong>A three-stage search was conducted to identify interventions used to improve access to NHS general practice. Using an iterative process, we generated thematic categories to classify interventions according to how they are intended to work. We assessed which aspects of access they addressed using the seven-feature Candidacy Framework.</p><p><strong>Results: </strong>The search identified 449 relevant sources reporting on interventions to improve access to general practice over the period 1984-2023. We generated six overarching thematic categories into which we organised these interventions: appointment innovations; direct patient access to services; increasing the number and range of professionals available in general practice; offering contacts beyond core hours, core settings, and core services; supporting patient engagement; and supporting the wider structures of general practice. We assessed which features of candidacy were addressed, with 'permeability' (the ease with which people can use services) emerging as the most frequent feature.</p><p><strong>Conclusion: </strong>Multiple and diverse attempts have been made to improve access in general practice over a 40-year period. This curated, thematised catalogue offers an important resource for future efforts to improve access.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inequalities in cancer 2-week-wait referrals: a cross-sectional study in English general practice.","authors":"Stephanie C Wynne, Mark Ashworth","doi":"10.3399/BJGPO.2024.0052","DOIUrl":"10.3399/BJGPO.2024.0052","url":null,"abstract":"<p><strong>Background: </strong>Practices with higher 2-week-wait (2WW) referral rates demonstrate higher survival for several cancers. Yet, there is little up-to-date evidence exploring factors influencing 2WW referral rates and whether health inequalities exist, particularly after COVID-19.</p><p><strong>Aim: </strong>To establish which patient factors (for example, age, sex, ethnic group, deprivation) and practice factors (for example, remote consultations, frequency of seeing a preferred GP) independently predict 2WW referral rates.</p><p><strong>Design & setting: </strong>A cross-sectional, observational study was performed using data from English general practices for 2021-2022.</p><p><strong>Method: </strong>Multivariable linear regression was used to identify the strongest, independent predictors of 2WW referral rates for all cancers (primary outcome) and for breast, lower-gastrointestinal, lung, and skin cancers separately (secondary outcome).</p><p><strong>Results: </strong>The analysis included 6307 practices. Practices with more females, patients aged ≥75 years, and patients with a greater burden of long-term conditions were associated with higher 2WW referrals for all cancers, as were practices in Northwest England, and those with higher scores for patients feeling involved in care decisions. Conversely, practices with a higher frequency of seeing a preferred GP were predictive of fewer all-cancer 2WW referrals. Practices with a higher proportion of currently smoking patients and Asian and Black ethnicity patients also predicted fewer all-cancer 2WW-referrals, and these associations were strongest for skin cancer, and for breast cancer (except for Black ethnicity). Higher socioeconomic deprivation predicted lower 2WW referrals for lung cancer only.</p><p><strong>Conclusion: </strong>This study analyses factors influencing 2WW referral rates and highlights potential inequalities. This work identifies priority populations, including people who smoke, and Asian and Black ethnic group patients, who may benefit from interventions to increase primary care access. Shared decision making may be an underexplored resource for increasing all-cancer 2WW referral rates.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Content and timing of the 6-8 week maternal postnatal check: a mixed-methods study.","authors":"Clare Macdonald, Fiona Cross-Sudworth, Laura Quinn, Christine MacArthur, Debra Bick, Ellie Jones, Beck Taylor","doi":"10.3399/BJGPO.2024.0229","DOIUrl":"10.3399/BJGPO.2024.0229","url":null,"abstract":"<p><strong>Background: </strong>Since 2020, the General Medical Services contract requires GP practices in England to offer women a GP appointment 6-8 weeks after birth: the '6-8 week postnatal check' or 'consultation'. Historically, provision of checks was variable, and women still frequently report poor experiences.</p><p><strong>Aim: </strong>To explore GPs' and women's perspectives of the 6-8 week postnatal check, including key components and timing.</p><p><strong>Design & setting: </strong>A mixed-methods study was undertaken with focus groups of GPs and women, and an online survey of GPs in England.</p><p><strong>Method: </strong>Focus groups explored GPs' and women's experiences of postnatal consultations. An online survey explored GPs' clinical approach, organisation, and improvement potential. Quantitative analysis examined associations between demographics and clinical approach. Thematic framework analysis was used for qualitative data.</p><p><strong>Results: </strong>In total, 18 women and 14 GPs participated in focus groups; 671 GPs completed the survey. Mental wellbeing and contraception were reported as important topics, although some women were not asked about mental health. GP survey responses indicated most recommendations from national guidance were 'always' or 'very often' covered by most, but not all GPs. Clinical coverage was higher for GPs who used clinical templates, had awareness of guidance, were female, or were a parent. Many GPs (<i>n</i> = 326/670, 49%) needed more time than they were allocated for the consultation (<i>n</i> = 524/670 [78%] allocated ≤15 minutes; <i>n</i> = 351/670 [52%] completed in ≤15 minutes).</p><p><strong>Conclusion: </strong>This study suggests GPs are allocated insufficient time for postnatal consultations, with substantial variation in practice. Specifying consultation duration and consideration of template usage in policy may improve care and outcomes for women.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Could a behaviour change intervention be used to address under-recognition of work-related asthma in primary care? A systematic review.","authors":"Gareth Iestyn Walters, Harriet Foley, Christopher Charles Huntley, Anadil Naveed, Kimberley Nettleton, Christopher Reilly, Maximillian Thomas, Claire Walker, Kyrie Wheeler","doi":"10.3399/BJGPO.2024.0094","DOIUrl":"10.3399/BJGPO.2024.0094","url":null,"abstract":"<p><strong>Background: </strong>Work-related asthma (WRA) is prevalent yet under-recognised in UK primary care.</p><p><strong>Aim: </strong>To identify behaviour change interventions (BCIs) intended for use in primary care to identify WRA, or any other chronic disease (that could be adapted for use in WRA).</p><p><strong>Design & setting: </strong>A systematic review was conducted using narrative synthesis.</p><p><strong>Method: </strong>We searched Cochrane Central Register of Controlled Trials, Embase, PsycINFO, and Ovid MEDLINE databases (1946-2023) for studies describing development and/or evaluation of BCIs for case finding any chronic disease in primary care settings, aimed at either healthcare professionals and/or patients. Two blinded, independent reviewers screened abstracts and assessed full-text articles. We undertook narrative synthesis for outcomes of usability and effectiveness, and for BCI development processes.</p><p><strong>Results: </strong>We included 14 studies from 768 retrieved citations, comprising three randomised controlled trials, one uncontrolled experimental study, and 10 studies employing recognised multi-step behaviour change (BC) methodologies. None of the studies were concerned with identification of asthma. BCIs had been developed for facilitating screening programmes (five studies), implementing guidelines (three studies), and individual case finding (six studies). Five studies measured effectiveness, in terms of screening adherence rates, pre- or post-intervention competency, and satisfaction and usability, for clinicians, although none measured diagnostic rates.</p><p><strong>Conclusion: </strong>No single or multi-component BCIs have been developed specifically to aid identification of asthma or WRA, although other chronic diseases have been targeted. Development has used BC methodologies that involved gathering data from a range of sources, and developing content specific to defined at-risk populations, so are not immediately transferable. Such methodologies could be used similarly to develop a primary care-based BCI for WRA.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhaled corticosteroids for COVID-19: a real-world data analysis on guideline adherence.","authors":"Jasper Wa van Egeraat, Ton Kuijpers, Jako Burgers, Hendrikus van Os, Niels H Chavannes, Tobias N Bonten","doi":"10.3399/BJGPO.2024.0135","DOIUrl":"10.3399/BJGPO.2024.0135","url":null,"abstract":"<p><strong>Background: </strong>The recommendation to consider prescribing inhaled corticosteroids (ICSs) to a subgroup of vulnerable patients with COVID-19 was added to the Dutch medical guideline on 2 November 2021, and was also adopted by other countries during the pandemic.</p><p><strong>Aim: </strong>To evaluate the adherence of GPs to this guideline, and whether the quality of real-world data is sufficient to study the effect of revised guidelines on prescribing behaviour.</p><p><strong>Design & setting: </strong>A retrospective cohort study using Dutch primary care data from the Extramural Leiden University Medical Center (LUMC) Academic Network database, containing patient data of 129 general practices in the Leiden - The Hague area.</p><p><strong>Method: </strong>We performed an interrupted time series analysis to measure the effect of the new recommendation on the prescription rate of ICSs, accounting for general trends and seasonal fluctuations.</p><p><strong>Results: </strong>Between 1 July 2020 and 1 August 2022, 131 482 patients had 164 098 COVID-19 consultations. During this period, 1709 patients received 2094 ICS prescriptions for COVID-19. After the guideline update, there was an instantaneous decrease in prescription rate (incidence risk ratio [IRR] 0.47, 95% confidence intervals [CI] = 0.32 to 0.69). Prescription rate in the subgroup of vulnerable patients did not change significantly (IRR 0.93, 95% CI = 0.66 to 1.32), while less vulnerable patients were prescribed significantly fewer ICSs (IRR 0.29, 95% CI = 0.14 to 0.59).</p><p><strong>Conclusion: </strong>The revision to the COVID-19 guideline had significant impact on GPs' prescribing behaviour soon after publication: prescription rate remained constant for vulnerable patients, while less vulnerable patiens received ICS prescriptions significantly less often. Using electronic health records it is feasible to assess changes in guideline adherence using interrupted time series.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular risk estimation and statin adherence: a historical cohort study protocol.","authors":"Samuel Finnikin, Brian Willis, Rani Khatib, Tim Evans, Tom Marshall","doi":"10.3399/BJGPO.2024.0258","DOIUrl":"10.3399/BJGPO.2024.0258","url":null,"abstract":"<p><strong>Background: </strong>Adherence to statins for the primary prevention of cardiovascular disease (CVD) is low. There is evidence that some facets of the initiation consultation, or the initiating clinician, are associated with adherence. CVD risk estimation is fundamental to statin initiation and shared decision making (SDM), because the benefits of statins are proportional to CVD risk. Absence of a recorded CVD score before statin initiation therefore indicates that SDM is unlikely.</p><p><strong>Aim: </strong>To investigate whether SDM, using the CVD risk score as a proxy measure, is associated with adherence to statins and CVD outcomes.</p><p><strong>Design & setting: </strong>A retrospective cohort study using a database of English primary care records.</p><p><strong>Method: </strong>The cohort will include statin-naïve patients aged 40-84 years initiated on statins for primary prevention between 2017 and 2020, categorised by the presence or absence of a CVD risk score at statin initiation. Statin adherence and persistence will be determined from subsequent statin prescriptions. Multivariable modelling, accounting for potential confounders, will determine the association between a recorded CVD risk score and subsequent statin adherence and with statin persistence. A secondary analysis will investigate the relationship to subsequent CVD outcomes and death.</p><p><strong>Conclusion: </strong>This research uses a record of CVD risk score as a proxy for SDM, to investigate the link between SDM and medication adherence. It will shed light on the relationship between how the initiation consultation is performed and subsequent adherence and persistence with treatment.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}