LOGIC March 2018 Vol 17 Vol 1 - Page 26

• practice service delivery requirements. Practice nurses may also have the opportunity to encourage patients to access cardiac rehabilitation after a cardiac event or make a referral to a Cardiology Clinical Nurse Specialist. b. Patient education regarding statins • Ensure patients understand their CVD risk and the effectiveness (benefits) and safety of statins so they can make an informed decision about statin therapy • Provide information on statin adverse effects and the absolute risks – dispel any myths to reduce anxiety that may impact negatively on adherence. • Ensure patients understand their risk factors for myopathy and how to minimize any modifiable risks such as diet. Ensure patients know what to do if they experience muscle pain or other adverse effects i.e. contact their general practitioner (GP) or practice nurse (PN). March 2018 L.O.G.I.C Explain the different types of myopathy and signs to be aware of. • Ensure patients understand there are a number of strategies to follow if they experience muscle pain or other side effects, and for most people, these strategies will allow a person to tolerate statin therapy successfully. c. Check patients’ adherence with their statin (and other therapy) • A referral may need to be made for medication management services such as Medicines Use Review or Community Services/District Nursing support for taking medications. • Seek physician input for statin management strategies including dose, frequency and potency adjustments if a patient is experiencing SAMS. d. Monitor risk factors • Ensure lipid levels are undertaken at the correct frequency, along with weight, waist circumference and BP. Calculate Body Mass Index (BMI) and seek physician input for any required dose titrations of medication. Summary Nurses are an integral part of the multi-disciplinary health team and have a significant part to play in supporting patients to be adherent with statin therapy to maximize lipid lowering and reduce their CVD risk. Reference List: Best Practice Journal Team. (2014, April). News updates: Simvastatin and atorvastatin: beware of potential CYP3A4 interactions when prescribing other medicines. Best Practice Journal. Retrieved from https://bpac.org.nz/BPJ/2014/ April/news.aspx Best Tests Team. (2014, August). Investigating myalgia in patients taking statins. Best Tests. The Best Practice Advocacy Centre New Zealand. Retrieved from https://bpac.org.nz/BT/2014/A ugust/myalgia.aspx Chaudhary, R., Garg, J., Shah, N., & Sumner, A. (2017). PCSK9 inhibitors: A new era of lipid lowering therapy. World Journal of Cardiology, 9(2), 76–91. http://doi.org/10.4330/wjc.v9.i 2.76 Harbman, P. (2014). The development and testing of a nurse practitioner secondary 24