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Pharmacists are failing to accurately identify patients who are eligible for over-the-counter statins and may be inadequately trained to assess cardiovascular risk, a new study suggests.

News of the research came as it emerged that higher doses of statins are next on the Government's OTC agenda.

Nearly a third of patients identified by pharmacists as eligible for 10mg simvastatin did not need the drug or should have been referred to their GP, researchers found. A further third were incorrectly excluded from treatment.

In the study, 160 people completed questionnaires under pharmacist supervision and 53 were placed in the moderate risk group eligible for 10mg simvastatin.

But after protocol review, the researchers found nine people were at lower than moderate risk and seven had additional risk factors such as high blood pressure warranting GP advice, while 16 additional people fell within the moderate-risk category.

The authors, based at the University of Bradford, concluded pharmacists needed more training and support when assessing risk but insisted pharmacy-based risk assessments could be made to work.

The study, published in the Pharmaceutical Journal last month, came as an adviser to the drug industry told Pulse higher doses of statins could be next to move OTC.

Dr John Blenkinsopp, a clinical pharmacologist who is currently advising pharmaceutical firms on five applications to reclassify prescription medicines, said: 'To increase the strengths we need to review the data, but while I'm not too sure if we're ready for 40mg statins, I'm pretty certain we're ready for 20mg.'

GPs reacted with concern to the news, suggesting the Government needed to first concentrate on sorting out issues relating to the availability of the 10mg dose.

Dr Anthony Brzezicki, prescribing lead for Croydon PCT, said pharmacies' methods were 'flawed' because they failed to take into account factors such as smoking and blood pressure.

'The chemists are getting the statins at a ridiculously low price. There are massive incentives to initiate a statin.'

Professor Tony Avery, chair of the UK Drug Utilisation Research Group and a GP in Nottingham, called for evaluation of 10mg simvastatin: 'Before bumping up the doses let's have a bit more analysis.'

By Rob Finch

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