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Published in: BMC Public Health 1/2013

Open Access 01-12-2013 | Research article

Evaluating an implementation strategy in cardiovascular prevention to improve prescribing of statins in Germany: an intention to treat analysis

Authors: Heidemarie Keller, Oliver Hirsch, Petra Kaufmann-Kolle, Tanja Krones, Annette Becker, Andreas C Sönnichsen, Erika Baum, Norbert Donner-Banzhoff

Published in: BMC Public Health | Issue 1/2013

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Abstract

Background

The prescription of statins is an evidence-based treatment to reduce the risk of cardiovascular events in patients with elevated cardiovascular risk or with a cardiovascular disorder (CVD). In spite of this, many of these patients do not receive statins.

Methods

We evaluated the impact of a brief educational intervention in cardiovascular prevention in primary care physicians’ prescribing behaviour regarding statins beyond their participation in a randomised controlled trial (RCT). For this, prescribing data of all patients > 35 years who were counselled before and after the study period were analysed (each n > 75000). Outcome measure was prescription of Hydroxymethylglutaryl-CoA Reductase Inhibitors (statins) corresponding to patients’ overall risk for CVD. Appropriateness of prescribing was examined according to different risk groups based on the Anatomical Therapeutic Chemical Classification System (ATC codes).

Results

There was no consistent association between group allocation and statin prescription controlling for risk status in each risk group before and after study participation. However, we found a change to more significant drug configurations predicting the prescription of statins in the intervention group, which can be regarded as a small intervention effect.

Conclusion

Our results suggest that an active implementation of a brief evidence-based educational intervention does not lead to prescription modifications in everyday practice. Physician’s prescribing behaviour is affected by an established health care system, which is not easy to change.

Trial registration

ISRCTN71348772
Appendix
Available only for authorised users
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Metadata
Title
Evaluating an implementation strategy in cardiovascular prevention to improve prescribing of statins in Germany: an intention to treat analysis
Authors
Heidemarie Keller
Oliver Hirsch
Petra Kaufmann-Kolle
Tanja Krones
Annette Becker
Andreas C Sönnichsen
Erika Baum
Norbert Donner-Banzhoff
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2013
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-13-623

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