Clinical InvestigationHepatotoxicity Fears Contribute to Underutilization of Statin Medications by Primary Care Physicians
Section snippets
Survey Sample
We enrolled faculty and resident primary care physicians from university-based medical centers across the United States from December 2008 to April 2009. Physicians with prior training in gastroenterology or hepatology were excluded from the study. This sample was chosen because academic and trainee physicians may be more aware of current guidelines regarding statin use than community physicians.
Participants were recruited by mailing the questionnaire to residency program directors of internal
RESULTS
The survey was mailed to 138 residency program directors as described above, and survey responses were received from 937 physicians. Characteristics of respondents are shown in Table 1.
DISCUSSION
In this nationwide survey of primary care physicians, respondents were less likely to prescribe statins for patients with proven indications if the patient had elevated liver transaminase values, particularly with a diagnosis of hepatitis C. The majority of the respondents indicated that they monitor liver transaminase values more frequently than the guidelines recommend. Many respondents had falsely elevated perceptions of statin hepatotoxicity risk, and these risk perceptions correlated
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2022, Journal of HepatologyCitation Excerpt :Physicians are also concerned about hepatotoxicity when prescribing some drug classes, which may prevent necessary therapy. A survey conducted among over 900 primary care physicians in the US showed that 71% of respondents would prescribe statins to patients with clear indication but this proportion decreased to 50% if the patient concomitantly had baseline elevated transaminases and to 40% if there was a history of underlying liver disease, although a selection bias among respondents cannot be excluded.120 Interestingly, although frequently claimed in liability trials from a forensic perspective, the assessment of psychological disability after DILI is a neglected area of research.
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Drs. Rzouq and Volk contributed equally to this study. Each is considered to be the first author of this article.
This study was supported in part by a grant from the American Gastroenterological Association (to MLV).