Statin initiation by GPs in WA - A structured vignette study

BACKGROUND Statins are recommended for all patients with known coronary heart disease. This pilot study investigated statin initiation by a Western Australian general practitioner cohort and the influence of prescriber and patient characteristics on prescribing. METHODS A structured vignette questionnaire was posted to members of the Fremantle GP Network. Respondents indicated their prescribing decisions for nine hypothetical patients who had recently suffered a myocardial infarction. Data analysis utilised logistic regression analyses and a generalised linear model with a logit link function. RESULTS Fifty-five GPs responded (16.0% response rate). In over 20% of cases a statin was not prescribed. Male (OR 4.71; 95% CI: 1.24–17.87) and GPs with fewer years in practice (4.50; 1.21–16.77) were more likely to prescribe appropriately. Younger patients (2.21; 1.38–3.53), and those with diabetes (1.74; 1.09–2.76) or hypercholesterolaemia (4.81; 2.88–8.03) were more likely to receive therapy.