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Primary prevention cardiovascular indicator planned for QOF

By Christian Duffin

Exclusive: NICE wants to push and pilot a QOF incentive for the primary prevention of cardiovascular disease – despite recent research suggesting statins do not reduce mortality in people at increased cardiovascular risk.

The independent QOF indicator advisory committee will pilot an indicator incentivising GPs to prescribe statins for people with newly diagnosed hypertension with a 10 year CVD risk of 20% or more.

But a meta-analysis published in June in The Lancet - involving data from over 65,000 patients without heart disease - found the use of statins ‘was not associated with a statistically significant reduction in the risk of all-cause mortality'.

A NICE spokesperson said the organisation had examined the new research but added: ‘The advisory committee made its earlier recommendation following an assessment of the evidence base presented in the NICE lipid modification guideline and will discuss the results of piloting and consultation when making its final recommendations.'

Professor Mike Kirby, professor in health and human sciences at the University of Hertfordshire and a GPSI in cardiovascular disease, backed the decision to hold the pilots. He said the new research should be treated with caution because meta-analyses draw results from many different trials, and some are not reliable.

He added that trials like ASCOT showed statins could be effective in primary prevention. ‘It showed that giving 10mg of atorvastatin daily to patients with high blood pressure had a significant reduction in cardiovascular events.'

NICE is pressing ahead with a primary prevention cardiovascular indicator for QOF

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