I have been doing locums half time for the past 4 years. Prior to that I worked as a full-service family physician and as a medical coordinator at a care home for 25 years. I agree completely with Dr Eppler’s letter [BCMJ 2013;55:184] that there seems to be much unnecessary prescribing of statins to people near the end of life.
I would also add that cholesterol testing is being done far too often in people where it isn’t warranted. For example, I saw a 30-year-old woman with no risk factors who wanted a cholesterol test repeated. It had been done 1 year ago for reasons unclear to me and her numbers were excellent. I had little trouble explaining why I didn’t think this was needed. She accepted my reassurance.
I see a lot of young adults who want cholesterol tests done regularly and many healthy elderly patients (over 80) getting regular cholesterol tests and being prescribed statins for primary prevention. Where is the evidence for this? The few studies I have seen have shown no benefit in either of these situations. How many precious health care dollars are being spent? How many people are having side effects from meds that are unlikely to benefit them? I recently listened to the Therapeutics Initiative’s webcast about testing cholesterol levels too frequently and encourage all doctors ordering cholesterol tests to listen to it.
—John Miller, MD
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