Prescribing behaviour according to Dutch and European guidelines on the management of hypercholesterolaemia (1992-1999).

Background: The success of the full implementation of a new guideline may depend on the observed discrepancy between daily medical practice developed before the release of the guideline and new treatment recommendations issued by the guideline.

Aim: To assess whether the initiation of statin treatment for primary prevention of cardiovascular disease in an elderly population was in agreement with guidelines.

Methods: Data were obtained from the Rotterdam Study, a prospective population-based cohort study consisting of 7983 subjects aged>or=55 years.

Suboptimal choices and dosing of statins at start of therapy.

Aim: To assess dosing and determinants of the choice of statins among starters of statins.

Methods: Data were obtained from the PHARMO database comprising pharmacy and linked hospital discharge records of approximately 300 000 subjects in the Netherlands. All new users of statins in 1998 were selected.

Decrease of antiparkinsonian drugs before start of an antipsychotic in patients on levodopa treatment?

Introduction: Antiparkinsonian drugs can induce behavioural disturbances, which should be treated by first reducing antiparkinsonian drugs and/or starting a benzodiazepine. If this approach fails, then antipsychotics can be considered. The aim of this study was to determine how often antiparkinsonian drugs are decreased and benzodiazepines are started in levodopa users before start of an antipsychotic drug.

Pre-randomization decisions and group stratification in a randomized controlled trial to improve prescribing.

Objective: To select and evaluate characteristics of primary care practice groups relevant for stratification prior to randomization.

Method: Structured telephone interviews and pre- and post-intervention prescription data.

Setting: Additional study in an RCT to rationalize prescribing in primary care, addressing groups of pharmacists and doctors.

Failure to continue lipid-lowering drug use following the withdrawal of cerivastatin.

Background: Persistence with lipid-lowering drug use is important in order for patients to gain full treatment benefit. The withdrawal of cerivastatin from the market may have affected persistence due to the fear of serious adverse effects.

Objective: To assess failure of patients to continue lipid-lowering drug use following the withdrawal of cerivastatin.