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Gold, incentives and meh

Contract can prevent 7,000 CHD deaths every year

The new GMS contract could prevent more than 7,000 deaths from heart disease every year by giving GPs an incentive to step up their prescribing of statins, ACE inhibitors and antihypertensives, according to the Government's heart tsar.

But Dr Roger Boyle also warned that GPs could not shoulder the workload burden on their own.

He said GPs had played a big part in bringing CHD mortality down by 23.4 per cent since 1996 ­ but latest data showed there was still room for improvement in statin use and cholesterol testing.

He presented research at the CHD Collaborative annual meeting in London last week showing just 59 per cent of patients with CHD are taking statins. Of this group, 53 per cent had not had any objective monitoring such as cholesterol testing.

The quality framework would offer a 'powerful incentive' for GPs to meet targets in the national service framework for CHD, added Dr Boyle.

He said that while smoking cessation targets had the potential to prevent 720 CHD deaths per year, improved prescribing in the wake of the quality framework could have a much more dramatic impact.

He estimated that:

·wider use of statins could prevent 2,600 deaths through secondary prevention and 600 deaths through primary prevention every year

·greater use of ACE inhibitors could save 2,900 lives a year

·wider prescribing of other antihypertensives had the potential to prevent 1,500 deaths annually.

But Dr Boyle added: 'If statin prescribing increases at its current rate of 30 per cent per year GPs would end up writing 61 million prescriptions per year by 2010. They would be spending all their time writing prescriptions.'

Alternative measures such as putting statins over the counter would be needed, he suggested.

By Brian Kelly

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