[Increased use of lipid-lowering agents after implementation of clinical guidelines in general practice]

The preventive efforts with respect to ischaemic heart disease are inadequate, and particularly an under-use of lipid-lowering drugs (LLDs) has been demonstrated. The aim of this study was to examine if the prescribing of LLDs increased after an intervention. The intervention consisted of clinical guidelines on prevention of ischaemic heart disease sent to all general practitioners nationwide, accompanied by a change of reimbursement rules for LLDs.

The clinical guidelines were made by the Danish College of General Practitioners and sent out simultaneously with the introduction of less restrictive reimbursement rules for LLDs in December 1998. Prescriptions for lipid-lowering drugs were analysed based on prescription data in the Odense University Pharmacoepidemiological Database.

The consumption of LLDs increased significantly after the intervention. The incidence rate ratio (before/after) was 1.43 (1.35-1.52). Prior to the intervention there was an average annual increase in the prevalence of LLD users of 0.2%. After the intervention the prevalence increased by 0.4%. For patients with diabetes, the figures were 1.2% and 2.3% and for patients with ischaemic heart disease 5.0% and 8.1%, respectively.

Clinical guidelines on prevention of ischaemic heart disease accompanied by a change of drug reimbursement rules had a significant influence on the prescribing of LLDs. The number of persons treated with LLDs is, however, still too low.