Pharmacists’ perceived integration into practice of over-the-counter simvastatin five years post reclassification

Abstract

Background Simvastatin 10 mg was reclassified in 2004 to over-the-counter (OTC) status in the UK, indicated for the prevention of a first major coronary event in individuals at moderate risk of the event. The primary reason behind the reclassification was to reduce the burden of disease management in general practice. Community pharmacists’ adoption of OTC simvastatin into practice immediately post reclassification was reported to below but there has been no systematic update on current practice. Objective The aim was to investigate pharmacists’ adoption into practice, and attitudes to, OTC simvastatin 5 years post reclassification in the UK. Setting Community pharmacists at all community pharmacies in Scotland. Method A pre-piloted postal questionnaire was distributed to all community pharmacies in Scotland (N = 1138). Self rated adoption was measured on a five point scale. Factors associated with decision making were investigated using a 24-item Likert-type agreement scale. Main outcome measure Pharmacists’ perceived integration of reclassified simvastatin; factors associated with decision making. Results Response rate was 49.5 % (n = 563). A high majority reported not supplying the reclassified medicine mainly owing to a perceived lack of evidence, low patient demand, customer complaints about the retail price and lack of access to patient medical records. A minority agreed to reclassification being an opportunity for their role development. Conclusions Community Pharmacists’ views of reclassified simvastatin supply 5 years post reclassification, as compared to the time it was newly reclassified, suggest low uptake. This lack of progress over time suggests that, against policy initiatives, OTC availability is unlikely to have impacted on the level of general practice led management of patients at risk of coronary events.