QRISK introduction set to increase scrips of statins

New risk tool will identify patients for CVD primary prevention.

The introduction of QRISK as the cardiovascular risk tool for England and Wales could increase use of statins, cardiovascular experts have warned.

Draft lipid modification guidance issued last week by NICE recommends the use of QRISK over the currently used Framingham tool, which is thought to overestimate cardiovascular risk in the UK population.

Despite this, Nottingham GP Professor Julia Hippisley-Cox, co-author of QRISK, said the new risk calculator will boost the number of patients taking statins.

'QRISK will increase the number of patients from deprived areas and the number of women who will require statins,' she explained.

'Patients that have been identified as being at high risk of cardiovascular disease (CVD) will remain on statins, so QRISK will not take any patients off statins.'

Dr Terry McCormack, chairman of the Primary Care Cardiovascular Society (PCCS) and a GP in Whitby, north Yorkshire, said statin prescribing for primary prevention was underused in the UK.

'If QRISK encourages prevention risk scoring and makes GPs more confident they are selecting the right people to prescribe for, it might increase statin prescribing,' he said.

But Surrey GP and PCCS member Dr John Pittard said: 'Most things that NICE do are about cost-effectiveness so it is likely that the introduction of QRISK will lower statin prescribing.

'Fewer people at low risk of CVD will be prescribed statins in favour of more people from high-risk groups.'

The DoH has attributed the increased use of statins for meeting its target of cutting CVD mortality by 40 per cent in the under-75s five years earlier than expected.

In England, statin scrips have more than doubled over the past three years, with 12,000 written in 2007.

sanjay.tanday@haymarket.com

NICE draft guideline on lipid modification

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