International Journal of STD & AIDS > Volume 20, Number 3 > Pp. 202-204

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Audit reports

Devolving of statin prescribing to general practitioners for HIV-infected patients receiving antiretroviral therapy

P D Benn MBChB MRCP  ^*, R F Miller MBBS FRCP , L Evans LLB MBBS ^*, J Minton BPharm MRPharmS  and S G Edwards MBChB FRCP ^*

^* Department of Genitourinary Medicine, Camden PCT, The Mortimer Market Centre, Off Capper Street, London WC1E 6JB; Centre for Sexual Health and HIV Research, Royal Free and University College Medical School, University College London, London; University College Hospitals NHS Foundation Trust, London, UK

Correspondence to: Dr Paul Benn Email: paul.benn{at}camdenpct.nhs.uk

Serious adverse events and medication errors are common in clinical practice and are associated with significant morbidity and mortality. Management of HIV-positive patients is likely to become more complex as people age, developing multiple medical conditions and thus requiring polypharmacy. We undertook a casenote review and interview of patients on antiretroviral therapy (ART) to audit the safety of devolving statin prescribing to general practitioners (GPs). Of 26 patients only 50% had their statin prescribing successfully been devolved to GPs. Many experienced significant difficulties and two of 26 (8%) were switched to simvastatin while receiving a protease inhibitor. We demonstrate that prescribing ART and non-ART medication by different practitioners on different sites can potentially expose patients to serious life-threatening adverse events. We make recommendations to minimize these risks and suggest that care pathways are reviewed to ensure they remain both convenient and user-friendly without compromising patient safety.

Key Words: HIV • antiretroviral therapy • statins • drug–drug interactions • general practitioners

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