Statins

My dogs too are really happy with the extra walkies! Sounds like you're doing everything possible Merlot . It's hard isn't it?

the type of statin matters a great deal, gps prescribe the cheapest which is Simvastatin, and that has greatest side affects ie muscle pain.

I wason that for couple months and my legs ached so much I insisted it was changed, got the usual cost to n hs as Atorvastatin am on now is more expensive a lot more, but I replied my husband has worked hard all his life putting money into nhs I do no want to be economised on.

It got changed, then about 2 years ago got letter saying been altered again, once again I wrote back and got it altered, you have to really look out for yourself as sadly most gps think budget which they are forced to do in fairness.

I am not on them because of cholesterol but trigylycerides which is another fat level in blood, and my father died at 60 massive coronory which makes them cautious for you thankfully!!

My poor old mum would probably still be able to walk if she hadn't been prescribed simvastatin. She had a stroke five years ago aged 89 and was put on a cocktail of drugs (her prescription is three pages long). She needed a zimmer frame to get about because the stroke left her weak on one side but she could get out and about with members of the family. Once she developed pains her legs that was it. She now has to be hoisted out of bed and into her chair. Mum has not had a review of her medication in all this time so I rang her GP a couple of months ago to question this. All he said was, 'Everything's fine, there's no need to change anything.' I can't remember the last time he visited her.

That's awful Merlot.
I had an old aunt who lived out in the country a few miles from Penzance and her GP practice did an annual assessment of her needs (GP coming to the house) in addition, of course, to anything else she needed.
I think there is a rule that repeat prescriptions have to be reviewed every 12 months - it certainly says that on mine. I take thyroxine and have to have a blood test every year to make sure the dose is still right.
Perhaps you could suggest to the GP that 'review' does actually mean a physical examination of his patient in order to carry out a proper assessment.
this article describes the potential dangers of polypharmacy in older people - adverse drug reactions and interactions, poor compliance and confusion.

www.bbc.co.uk/news/health-16137013
Check out this link. Over 40's should be offered health checks. Your mother is being treated disgracefully merlot.

Interesting article jane and so true.

Thanks Nanad.
I wonder how many of us have been offered these checks at our GP practices.
A friend who used to work in hospital administration once told me (some years ago now, so perhaps things are changing) that the NHS isn't really interested in screening, because of all the illness it would uncover and the costs of treating it!!
The only reason we have breast cancer screening and cervical cancer screening is because of powerful lobbying from women's groups.
Screening for man-diseases like prostate cancer and heart disease has lagged a long way behind.

I suspect that one of the reasons that France has a good reputation for health care is because of all the screening. I don't understand putting people on statins at eighty though.
My doctor (retiring shortly boo-hoo) always says that giving up cheese / cream / wine might let you live a bit longer, but it would feel like a very long time.

I like that Mamie
I recently had to see an ENT consultant and during the usual interrogation confessed that I did sometimes go over the recommended alcohol intake.
He said that the recommendations were based on old flawed evidence, and as long as you weren't drinking more than your doctor, you were doing ok

Not OK if your doctor's tee-total, though...

Our ex next door neighbour who was a doctor , used to get through a bottle of whiskey a day . He eventually died of liver failure, quite sad really as he was nice person

Anagram that would definitely be too much information

I do worry about 'informed decision' via the internet though. There is an awful lot of rubbish on the net. In the UK we are very lucky that GPs and specialists are NOT directly connected to financial gain via prescribing. Why on earth would my GP spend a lot of time talking to me about why statins could prevent heart problems and strokes- when it makes no difference to the way they are paid? I have an excellent GP I can truly trust - and he is on statins too, because he has spend much time studying the issues, and has come to the conclusion it can really help him avoid severe conditions related to his health. Why would he take them if he didn't believe it is beneficial?

Agreed that it makes no sense to me, or to my GP, to put everyone over 50 on statins - but it does make sense for many patients with a history of such in their family, and due to other conditions. My mother never had statins has it was 'before' her time- as her legs failed her, and her sight, memory, etc - it would have been 'easy' to conclude that statins had caused all this - had she been prescribed them?

A friend of our was stick thin, and had a very healthy vegetarian diet. His doctor found that he had high cholesterol and wanted to put him on statins- but he refused, having read so much negative things on the internet. He died of a massive heart attach in his early 60s - and his wife considered suing the GP because he did not insist that he took statins! She didn't in the end- as she realised it was a non-starter.

It's not quite true that GPs pay isn't related to their prescribing patterns Granjura
They have Quality Outcome Frameworks (QOFs), ie targets, to adhere to, not all of them clinical though.
Recently there was a bit of an upset when practices which were failing to get their early morning slots and late evening slots filled, had money deducted from their contract values by the PCTs.
You can imagine the scene - the GPs sitting there twiddling their thumbs while the patients were at home enjoying their evening meals with their families, and getting their pay deducted too
That's why when i ring my practice to get an appointment I am offered the 7.15am slot, and the receptionist sounds less than pleased when I say I'd prefer to attend at a more civilised hour.
I don't know for certain if there's a QOF related to statins, but I think there is, for people considered at risk. This may change though, if the recommendation for all over 50's to have statins is implemented.

I thought I had read somewhere that doctors (or their 'businesses') get paid for prescribing statins too, but I couldn't remember where I'd seen it, so I'm not surprised by what you say, jane. Of course, just because it is recommended doesn't mean we have to take the things.

Yes it is very complicated - and yet ... why would he Government want to increase costs by putting people with conditions that could really be helped by, say statins- unless it made financial sense as well as medical sense. GPs are encouraged to discuss the benefits of statins if you have diabetes or heart disease and a raised cholesterol - but they can't force you to accept. Most GPs I know would have much preferred not being given quotas in exchange for financial gain, as they knew it would alter the trust between patient and doctor.
Look at immunisations for children and flu jabs for the elderly or with conditions that would make flu dangerous - it makes sense to encourage GPs to spend more time explaining the benefits. It can take a huge amount of time and patience to explain the benefits of immunisations to parents after the dreadful Wakefield accusations re: Crones and autism. And yet, for all the children to be safe form the return and disastrous effects of diseases like measles, you MUST have a high intake overall, approx 90+% - so time and effort to educate, explain, etc, is well worth while. And costly too - would the Government via NHS spend so much time and money to explain all this, just to benefit big pharmas- or because it saves lives?

GPs were also forced to open surgeries earlier and later to benefit working patients- so they could see a doctor before or after working hours. Makes no sense to offer those aps for retired patients at all - and as you say, no sense for a GP NOT to be eating his meal with her/his family if nobody wants the late/early aps!

I'm sure the Big Pharma can easily afford the 'publicity' for its drugs via GPs, and probably does. Why does anyone 'advertise'? Because it's profitable.

My first memory of a GP is of our family one from when I was nine years old. His surgery was a room in the house he lived in with his family, so he could easily be relaxing at home if there were no patients for early morning or evening surgery. At least, one supposes so, in theory, and the practice of it would be easier too, given the proximity of his family sitting-room.

I don't think there is any incentive for Doctors to prescribe statins. I broached the subject with my Doctor and he said it was no skin off his nose if I didn't take them. He said I required them but the onus was on me to actually take the tablets.

That's good then.

Bags and Harrigran I'm afraid it's not quite so simple as this article makes clear.
[quote]The prescribing adviser wants me to prescribe statin A this year. This patient is happy on statin B, which we switched him to some years ago as it was more cost-effective then. The prescribing lead partner wants me to persuade him to switch, which will allow us to stay green on the prescribing incentive scheme and protect our income.[quote]

and
[quote]Prescribing incentive schemes, started with the laudable intention of getting maximum value for limited resources, are being used to direct and limit clinical behaviour on flimsy evidence enforced by financial penalties.[quote]

Doctors are supposed to act in their patients' best interests, and we trust them to do that, but at the same time their arms are being twisted further and further up their backs by the government and the PCTs.

The Diabetes specialists are dismayed that so many patients are refusing Statins, due to so much fearmongering on the internet, etc. Statins could save 1000s with diabetes of heart attacks and strokes - and the side-effects are comparatively rare and minor. Having a quick heart attack and gone does not scare me too much - but having seen friends suffering the terrible consequences of a stroke, for years or forever, really makes me wonder why so many refuse them.

It's a bit like my friend who smoked 30 a day and drank like a fish, but said I was mad to take the Pill and put dangerous chemicals in my body (:

Is your friend still around GJ?

No, died of cancer about 10 years ago, sadly.

Oh dear, sorry GJ

Sadly and tragically, just got news of another friend who died due to mis-information about statins. He had a couple of stents put in a few years ago and was prescribed statins- but stopped taking them due to negative info from friends and press. Aged 54, had massive heart attack recently.
Tragic beyond belief.