Is general practice the optimal setting for the recognition of statin-induced myotoxicity?

Abstract

Background: Previous research has shown that routine monitoring appears to add little to the prognostication of incipient statininduced myotoxicity (SIM) in the primary care setting. In view of this, and the fact that there are now millions of patients on statins, it seems of practical value to delve deeper into the symptomatology of SIM. Aims: To estimate the prevalence of SIM in statin users as compared to non-users, and whether family practice is the ideal setting to identify SIM. Method: The first phase of the research was a retrospective, case-controlled study based on existing records of a single practice (n=7,608). This was followed by a second stage, prospective, exploratory study using a semi-structured survey on a random subsample (n=220). Results and discussion: Highly significant results were obtained in comparisons of data gathered from the first part of the study (ie, data from practice database) and the second stage (ie, data from the probing validated questionnaire), together with results showing a difference just below the threshold for significance between statin users compared to non-users in relation to upper limb weakness. Conclusions: Probing seems to be of utmost importance in detecting SIM. The results are in line with previous studies on the same topic conducted in settings other than primary care.