Prescription Trend in Antihypertensive Drugs in Mumbai And Suburbs: A Survey

Abstract

Objectives: To compare how clinicians manage patients with statin intolerance (SI) in Japan, South Korea and Taiwan. MethOds: A web-based survey was conducted in Japan between January-February 2014, and in South Korea and Taiwan between November-December 2015. In total, 180 specialists and general/family physicians (GPs) participated; they were required to have treated ≥ 75 and 50 patients with hypercholesterolemia, respectively, in the previous year, and ≥ 5 patients presenting with SI symptoms. Informed consent was provided. Results: Clinicians estimated a low prevalence of SI (Japan, 2%; South Korea, 0.3%; Taiwan, 2%). Clinicians in Japan were less likely to prescribe a low-dose statin to SI patients than in South Korea and Taiwan (mean proportion of case load: 29%, 61% and 56% respectively); 14% (Japan), 23% (South Korea) and 28% (Taiwan) of patients did not receive a concomitant nonstatin lipid-lowering therapy (LLT). Clinicians used non-statin LLT either as monotherapy or with a low-dose statin (Japan: 55%, 15%; South Korea, 23%, 38%; Taiwan, 37%, 28% respectively). A small proportion of SI patients received no therapy (Japan, 16%; South Korea, 16%; Taiwan, 7%). Within Japan and Taiwan, similar patterns were reported for specialists and GPs for use of low-dose statin and non-statin LLT treatment. However, a non-statin LLT was used by 70% of specialists and 53% of GPs in South Korea. Ezetimibe was the first choice non-statin LLT selected by clinicians as a monotherapy (Japan, 72%; South Korea, 47%; Taiwan, 80%) or in combination with a low-dose statin (Japan, 38%; South Korea, 50%; Taiwan, 82%), although GPs in South Korea preferred fish oil. cOnclusiOns: The estimated prevalence of SI was low across countries. Low-dose statins are used more frequently for SI patients in South Korea and Taiwan than Japan. Non-statin LLT was commonly prescribed with concomitant low-dose statin in South Korea and without in Japan and Taiwan.