Changes/additions to materials:

Ezetimibe and cancer — reassuring data
As we have blogged, an analysis of post-marketing adverse event reports did not find any increased risk of cancer with ezetimibe▼ compared with statins, either alone or when taken in combination with simvastatin. Although these data are reassuring, it would seem sensible to use ezetimibe▼ only with caution because there is no published evidence of its benefit on clinically important outcomes such as cardiovascular events and its long-term safety is unknown. Prescribers should continue to use evidence-based statins (e.g. simvastatin 40mg/day) first-line in most patients who require a lipid-lowering agent.

A MeReC Bulletin on lipid-modifying treatment is now available. It:

• addresses the similarities and differences between NICE guidance for people with and without type 2 diabetes
• provides clarification on NICE’s recommendations regarding thresholds for intensifying treatment
• discusses the evidence base for high-intensity statins, for rosuvastatin and for ezetimibe▼, the reliability of single cholesterol measurements, and the side effects of statins.

Note that some of the materials apply the black triangle (▼) to rosuvastatin. This was correct at their time of publication but the black triangle was removed by the MHRA in June 2007

The resources contained within this area are designed to help you assess an area for improvement or measure the effect of changes made to processes. You will also find tools and resources to use within medicines management processes.

Template for a practice-based audit —Low-cost statin prescribing

A template for practices to enable them audit their statin prescribing before, during or after a switching campaign. Can be used as a tool to monitor progress. Intended for adaptation according to local circumstances or preferences.

Template for Standing Operating Procedure —Switching patients from high cost to low cost statin

A template SOP for use by practices or PCTs switching from high cost to low cost statins. Contains basic framework that is suitable for local adaptation.

Statin switch letter

Sample of a letter that could be used to inform patients of a change to their medicines. Template for local adaptation.

Template information leaflet for patients

Template for an information leaflet containing basic information to support a local statin switching campaign.

Practice switch recording form
Template form to record patients switched from high cost to low cost statin. Includes columns for documenting follow up blood results and LFTs etc. Fully customisable to suit local policies.

Template for discussion points on statin switching
A template containing some possible discussion points for consideration as part of a local statin switching campaign. Intended for use in discussions with prescribers.

Statin switch tracker and impact assessment tool
A simple-to-use tool for monitoring progress of a local statin switching campaigns. Enables practices or PCTs to set switching targets for individual drugs and dose forms. Produces charts of progress and can be used to give feedback to individual prescribers or practices. Detailed instructions for use are contained in the associated file Statin review tool.

Statin review tool