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GPs call for better checks on pharmacist supply of statins



By Nigel Praities

GPs have called for an overhaul of guidelines for pharmacists supplying simvastatin over the counter, saying they should routinely conduct cholesterol and blood pressure checks.

The UK has allowed simvastatin to be sold OTC since 2004, but a new survey published this month shows that the majority of GPs think this is a bad idea.

The survey of 462 GP practices in Scotland – published in the British Journal of Clinical Pharmacology – found 56% believe the OTC sale of simvastatin 10 mg was ‘inappropriate’ and that it should be sold under stricter controls.

They also expressed alarm that pharmacists were not required to conduct blood pressure or cholesterol tests before supplying the drug, and called for pharmacists to be made responsible for any follow-ups.

60% of GPs thought blood pressure and cholesterol tests should be made compulsory and 83% said the pharmacist should be responsible for monitoring any side-effects in patients they have sold the drug to. 71% thought pharmacists should also be responsible for monitoring the cholesterol levels of patients they have sold simvastatin to.

The OTC product licence allows pharmacists to sell simvastatin OTC after a basic coronary risk check. If one of the following risk factors is present, then they are able to supply the drug: family history of CVD, smoking, obesity or South Asian origin.

Dr Derek Stewart, reader pharmacy practice at the Robert Gordon University in Aberdeen, concluded: ‘The lack of a formal CHD risk assessment using cholesterol and blood pressure measurements by the pharmacist was a source of concern to GPs as it has been to other professional groups.’

‘[But] more than half of respondents were supportive of statin prescribing by a pharmacist supplementary prescriber working within a patient specific clinical management plan.’

Brit J Clin Pharm: 2010; 70: 356–359

GP call for better checks on pharmacist supply of statins