Primary care gatekeeping and referrals: effective filter or failed experiment?

Abstract

was similar to that found in the single previous randomised controlled trial comparing five statins.5 We are aware that there have been no direct comparisons of the clinical outcomes in patients taking different statins and, realistically, such studies are unlikely.Initial serum cholesterol concentrations were higher in our study than in the randomised controlled trials, therefore the absolute risk reductions in primary care patients (and hence the overall population benefits) may be greater than thought.Achieving target cholesterol values of <5mmol/l may, however, be unrealistic.We thank the participating general practices; Andy Meal, Vicky Hammersley and Lynne Wright for advice on MIQUEST queries; and Lindsay Groom and Janet Yates for their comments on a late draft.

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