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Australian Journal of Pharmacy : May 2008
education aJPcPd CoNtINuINg ProfeSSIoNAl DeveloPMeNt CurreNt Drug INforMAtIoN Survey finds need for improved dialogue when dispensing statins a UK survey, which looked at patients’ and pharmacists’ views on interactions when dispensing prescriptions for statins were compared, has revealed some interesting findings.1 Twenty-five patients who were current or previous recipients of a statin on prescription, were interviewed. The semi-structured interviews explored the patients’ interactions with community pharmacists when first-time or repeat prescriptions were dispensed for statins. Topics discussed in the pharmacist interviews included roles the pharmacists currently perform when dispensing statins, and perceived responsibilities in relation to patients receiving the drugs. Most patients interviewed said they used the same pharmacy regularly to have their prescriptions dispensed. However, it was found that most patients reported little or no interaction when receiving either a first-time or repeat statin prescription. In contrast, most pharmacists reported that they routinely provided information about dosage and side-effects to patients receiving a statin for the first time. Their principal focus was on how to take the statin and information on any possible side effects. Some pharmacists also said that they gave lifestyle advice and explained why it is important to reduce cholesterol. When it came to repeat prescriptions for statins, patients’ and pharmacists’ accounts were similar, and indicated that pharmacists rarely initiate discussions about treatment. The pharmacists’ explanation for this was that they assumed the patient would already have received all the information they needed from other health professionals and that patients would ask if they had any further queries. It was concluded: ‘These findings indicate a gap between pharmacists’ perceptions of their interactions with patients receiving a first-time prescription for a statin and patients’ reported experience. Pharmacists may perceive that they provide more information than is actually the case. Pharmacists and patients agreed that when repeat prescriptions for statins are being dispensed, there is little or no discussion about the medicine. Pharmacists need to consider how they might elicit patients’ needs in a more systematic way’. n 1. Chatterton M, Blenkinsopp A, Pollock K. Statins and the interface between patient and community pharmacist. International Journal of Pharmacy Practice 2006;14:255–62. Statins have neutral effect on cancer and death risk Statins are cholesterol-lowering drugs that have been proven in randomised controlled trials to prevent cardiac events. There is some evidence from retrospective analyses that statins may also reduce the risk of developing cancer. This includes reductions in colon, breast, lung, and prostate cancers. However, as there are inherent biases and weaknesses associated with retrospective analyses, these studies cannot prove causality. Pharmacologically, statins may reduce cancer with reductions in inflammation, neovascular formation, and cell proliferation. To clarify matters, a meta-analyses was carried out to investigate the effect of statin therapy on cancer incidence and cancer death, and to analyse the effect of statins on specific cancers.1 A systematic literature search of appropriate databases was conducted using specific search terms. Twenty seven of the 8,943 articles (n=86,936 participants) initially identified met the inclusion criteria. These 27 articles reported: • 26 randomised controlled trials of statins, with a mean duration of follow-up of at least one year, enrolling a minimum of 100 patients; and • data on either cancer incidence (n=20 studies) or cancer death (n=22 studies). It was found in meta-analyses, including 6,662 incident cancers and 2,407 cancer deaths, statins did not reduce the incidence of cancer or cancer deaths. No reductions were noted for any individual cancer type. This null effect on cancer incidence persisted when only hydrophilic, lipophilic, naturally derived, or synthetically derived statins were evaluated. It was concluded: ’Statins have a neutral effect on cancer and cancer death risk in randomised controlled trials. We found that no type of cancer was affected by statin use and no subtype of statin affected the risk of cancer’. n 1. Dale KM, Coleman CI, Henyan NN, Kluger J, White CM. Statins and cancer risk: a meta- analysis. JAMA 2006;295:74–80. tHe AuStrAlIAN JourNAl of PHArMACy vol.89 MAy 2008 93