First prescriptions: lipid management

Introduction

This is the latest module in our series supporting pharmacists in their conversations with patients who are receiving a medicine for the first time. It covers medications used in the New Medicine Service in England but are relevant to all pharmacists in the UK.

This module covers the management of cardiovascular risk through lipid (cholesterol) lowering medication.

Contributing author: Alison Warren, consultant pharmacist, cardiology, Brighton and Sussex University Hospitals NHS Trust.

Key facts

• Cardiovascular disease (CVD) accounts for a quarter of all deaths in the UK but is largely preventable through lifestyle modification and lipid lowering therapy
• Lifestyle change is key to lowering cholesterol and CVD risk with particular reference to diet, weight management, exercise, smoking cessation and reducing excessive alcohol intake
• Drug therapy with statins (first-line for most people) or other medicines is very effective. Every 1mmol/L reduction in low density lipoprotein cholesterol (LDL-cholesterol) reduces the risk of a cardiovascular event by about 25 per cent
• The identification and offer of treatment with statins and/or other lipid lowering therapy remains a national priority to realise the benefits in the prevention and treatment of CVD
• Where muscle pain and/or weakness occur, they are generally reported in the first three to 12 months of statin treatment
• Shared decision-making is key to adherence to treatment with statins. Exploring any concerns the patient has is crucial.