Quality standard

Quality statement 5: Statins for primary prevention

Quality statement 5: Statins for primary prevention

Quality statement

Adults choosing statin treatment for the primary prevention of cardiovascular disease (CVD) are offered atorvastatin 20 mg.

Rationale

High‑intensity statins are the most clinically effective treatment option for the primary prevention of CVD – that is, reducing the risk of first CVD events. After a discussion of the risks and benefits of starting statin treatment with a healthcare professional, a person may choose statin treatment as an appropriate treatment to reduce their risk of CVD. When a person decides to have statin treatment, a statin of high intensity and low cost should be offered. Atorvastatin 20 mg is recommended as the preferred initial high‑intensity statin to use because it is clinically and cost effective for the primary prevention of CVD.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

Evidence of local arrangements to ensure that adults who choose statin treatment for primary prevention are offered atorvastatin 20 mg.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from local protocols.

Process

Proportion of adults choosing statin treatment for primary prevention of CVD who are prescribed atorvastatin 20 mg.

Numerator – the number in the denominator prescribed atorvastatin 20 mg.

Denominator – the number of adults choosing statin treatment for primary prevention of CVD.

Data source: Data on prescription of atorvastatin 20 mg can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient records. Publicly available national data on use of lipid lowering therapies in general practice patients is available from CVD Prevent's indicator CVD006CHOL. This reports the percentage of patients aged 18 and over with no GP recorded CVD and a GP recorded QRISK score of 10% or more, on lipid lowering therapy.

Outcome

Proportion of adults choosing statin treatment for primary prevention of CVD who have a greater than 40% reduction in non-high-density lipoprotein (HDL) cholesterol at 3 months of treatment.

Numerator – the number in the denominator who have a greater than 40% reduction in non-HDL cholesterol at 3 months of treatment.

Denominator – the number of adults choosing statin treatment for primary prevention of CVD.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient records.

What the quality statement means for different audiences

Service providers (primary care services) ensure that adults choosing statin treatment for primary prevention of CVD are offered atorvastatin 20 mg.

Healthcare professionals (GPs, nurse prescribers and pharmacists) offer atorvastatin 20 mg to adults choosing statin treatment for primary prevention of CVD.

Commissioners ensure that adults who choose statin treatment for primary prevention of CVD are offered atorvastatin 20 mg. Commissioners may do this by seeking evidence of practice through clinical audits.

Adults at risk of CVD who choose to have a statin to reduce their chances of CVD are offered one called atorvastatin. This may help to reduce their chances of having a heart attack or stroke in the future.