Evidence map›Paper›PMID 31015226›Full record

ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2019

Statins for primary prevention of cardiovascular disease: modelling guidelines and patient preferences based on an Irish cohort.

Paula Byrne, John Cullinan, Paddy Gillespie, Rafael Perera, Susan M Smith

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Observational
  2. Article
  3. Review
  4. Article
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Paula ByrneJE Cairnes School of Business and Economics, National University of Ireland, Galway, Ireland.
John CullinanJE Cairnes School of Business and Economics, National University of Ireland, Galway, Ireland.
Paddy GillespieJE Cairnes School of Business and Economics, and director, Health Economics and Policy Centre, National University of Ireland, Galway, Ireland.
Rafael PereraNuffield Department of Primary Care Health Sciences, University of Oxford, and NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Susan M SmithDepartment of General Practice, Royal College of Surgeons in Ireland, and Health Research Board Centre for Primary Care Research, Dublin, Ireland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChanges in clinical guidelines for primary prevention of cardiovascular disease (CVD) have widened eligibility for statin therapy.

aimTo illustrate the potential impacts of changes in clinical guidelines. DESIGN AND

settingModelling the impacts of seven consecutive European guidelines based on a cohort of people aged ≥50 years from the Irish Longitudinal Study on Ageing.

methodThe eligibility for statin therapy of a sample of people without a history of CVD was established, according to changing guideline recommendations and modelled associated potential costs. The authors calculated the numbers needed to treat (NNT) to prevent one major vascular event in patients at the lowest baseline risk for which each of the seven guidelines recommended treatment, and for those at low, medium, high, and very-high risk according to 2016 guidelines. These were compared with the NNT that patients reported as required to justify taking a daily medicine.

resultsThe proportion of patients eligible for statins increased from approximately 8% in 1987 to 61% in 2016; associated costs rose from €13.9 million to €107.1 million per annum. The NNT for those at the lowest risk for which each guideline recommended treatment rose from 40 to 400. By 2016, the NNT for low-risk patients was 400 compared to ≤25 very-high risk patients. The proportion of patients eligible for statins achieving NNT levels that patients regarded as justified to taking a daily medicine fell as guidelines changed over time.

conclusionIncreased eligibility for statin therapy impacts large proportions of the present population and healthcare budgets. Decisions to take and reimburse statins should be considered on the basis of expected cost-effectiveness and acceptability to patients.

Indexed as

AgedCardiovascular DiseasesCohort StudiesEligibility DeterminationFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsIrelandMaleMiddle AgedPatient PreferencePatient SelectionPractice Guidelines as TopicPrimary PreventionRisk FactorsHydroxymethylglutaryl-CoA Reductase Inhibitorsdrug costsguidelinehydroxymethylglutaryl-CoA reductase inhibitors, patient preferenceprimary prevention

Identifiers

PMID31015226
PMCPMC6532821

What OpenQuestion holds

Texttitle and abstract
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.