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Variations in GP prescribing of CHD drugs criticised as 'unjustifiable'

By Brian Kelly

There are unjustifiable variations in GP prescribing of coronary heart disease drugs, according to a Government-funded study of prescribing habits across more than 100 practices.

The researchers said prescribing seemed to be 'inequitable' on the basis of patient age, ethnicity, levels of deprivation and CHD mortality.

In general, prescribing of drugs including statins, ACE inhibitors, ?-blockers and aspirin were positively associated with the percentage of patients aged between 55 and 74 although prescribing rates were negatively associated with patients over 75.

The findings, published in the latest issue of the Journal of Epidemiology and Community Health (February), showed generally negative associations between prescribing rates and the proportion of south Asian patients within a practice.

Study leader Dr Peter Ward, lecturer in social science at Sheffield Hallam University, based his results on a review of prescribing analysis and cost data on CHD drugs from 132 practices across four PCTs in the north of England over a 12-month period.

He said: 'GP prescribing rates in some PCTs were negatively associated with health care need. As such, this study suggests prescribing rates in these PCTs may be inequitable.'

Dr Ward said the research would form the baseline for further assessment of the effectiveness of the national service framework for CHD in reducing inequities in prescribing.

He added: 'In addition to the correlations presented in the paper, the scatter plots also revealed mismatches in prescribing rates between individual practices, both within and between PCTs.'

Professor Francesco Cappucio, professor of primary care research and development at St George's Hospital Medical School, said research had already shown statin prescribing was lower in over-75s, in more deprived areas and in

areas with higher proportions of south Asian patients.

He added: 'This shows there is a long way to go before we address variations in some CHD services.'

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