Quality statement 8: 3‑month statin review

Quality statement

Adults on a high‑intensity statin have a repeat measurement of lipids and liver transaminases after 3 months of treatment.

Rationale

Repeating lipid profiles and measuring liver transaminases is important for patient safety and to ensure the effectiveness of statin therapy. A repeat lipid profile can be used to determine whether the expected 40% reduction in non‑high‑density lipoprotein (non‑HDL) cholesterol has been achieved. Repeat measurement of liver transaminase is important to detect any increased levels of these enzymes, which may indicate problems with liver function.

Quality measures

Structure

Evidence of local arrangements to ensure that adults on a high‑intensity statin have a repeat measurement of lipids and liver transaminases after 3 months of treatment.

Data source: Local data collection.

Process

Proportion of adults on high‑intensity statins who have had a repeat measurement of lipids and liver transaminases after 3 months of treatment.

Numerator – the number in the denominator who have had a repeat measurement of lipids and liver transaminases after 3 months of treatment.

Denominator – the number of adults prescribed high‑intensity statins for at least 3 months.

Data source: Local data collection.

What the quality statement means for service providers, healthcare professionals, and commissioners

Service providers (primary care) ensure that adults on a high‑intensity statin have a repeat measurement of lipids and liver transaminases after 3 months of treatment. Evidence should be made available on request to commissioners.

Healthcare professionals take a repeat measurement of lipids and liver transaminases after 3 months of treatment for adults on high‑intensity statins.

Commissioners (NHS England area teams and clinical commissioning groups) should monitor whether adults on a high‑intensity statin have a repeat measurement of lipids and liver transaminases after 3 months of treatment. Commissioners may wish to stipulate this in any local enhanced service specifications.

What the quality statement means for patients, service users and carers

Adults taking a statin have a review 3 months after their treatment starts to see if the statin is reducing their cholesterol levels and to check it is not affecting their liver.

Source guidance

Definitions of terms used in this quality statement

High‑intensity statin

The intensity of a statin is defined based on the percentage reduction in low‑density lipoprotein (LDL) cholesterol it can produce. A high‑intensity statin can produce a reduction above 40%. High‑intensity statins include:

  • atorvastatin 20 mg to 80 mg

  • rosuvastatin 10 mg to 40 mg

  • simvastatin 80 mg. (Lipid modification [NICE guideline CG181])