September 6, 2015

expert reaction to prescription thresholds and statins

An editorial published in the journal Prescriber has challenged the prescription thresholds of various medications, including statins, and suggested that lifestyle interventions were more critical.

Dr Tim Chico, Reader in Cardiovascular Medicine / consultant cardiologist, University of Sheffield, said:

“I completely disagree that treatment targets remove individual preference. These targets simply guide doctors as to which patients might benefit from a treatment. The decision whether to start or continue a drug treatment should always rest with the patient, with this decision guided by information from the doctor. I would never prescribe a statin without discussing it with my patient. Many patients differ in whether or not they decide to take a statin after a conversation about the risks and benefits of these treatments. Even the authors of this editorial would agree that after a heart attack, statins play an important role in reducing further heart attacks. I see hundreds of patients who take statins and other medications without any side effects and who are happy that we are doing everything possible to prevent them from another potentially fatal heart attack. This editorial seems to want to present a false choice between drug treatment or lifestyle factors such as diet, when both are important.”

‘Challenging treatment thresholds’ by McCormack et al. was published in Prescriber on Sunday 6th September.

Declared interests

Dr Tim Chico: No conflicts of interest