Timing of simvastatin treatment: No matter the time of day, does UK policy reflect the evidence?

doi:10.1136/bmj.328.7432.168-b

BMJ 2004;328:168 (17 January), doi:10.1136/bmj.328.7432.168-b

Letter

Timing of simvastatin treatment

No matter the time of day, does UK policy reflect the evidence?

The first 150 words of the full text of this article appear below.

EDITOR—Wallace et al highlight important issues on managingso called hyperlipidaemia.¹ The timing of the statin dose isirrelevant, with current policy and practice not designed todeliver the clinical outcomes seen in recent drug trials.² Theystudied suboptimal doses, which is common; data from the WestMidlands show that 36% of patients are prescribed simvastatin10 mg or pravastatin 10 mg (table).

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Proportions of pravastatin and simvastatin prescribed by general practitioners in West Midlands between July 2002 and June 2003

The national service framework for coronary heart disease seta target that statin treatment should aim to lower cholesterolbelow 5.0 mmol/l or to reduce total serum cholesterol by 20-25%,whichever would result in the lowest concentration.³ The qualityand outcome framework of the new general practitioners' contract⁴will reward according to the proportion of patients with vasculardisease, or diabetes, with total cholesterol concentrations. . . [Full text of this article]

Martin G Duerden, senior lecturer in therapeutics

martin@theduerdens.co.uk

Maria D Allinson, primary care trust prescribing support pharmacist, Jo Lockett, senior data analyst

Department of Medicines Management, Keele University, Staffordshire ST5 5BG

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