People who ordered their statins through the mail were more likely to control their cholesterol levels than those who had the prescriptions filled in a local pharmacy, according to a study of 100,298 people with high cholesterol enrolled in health plans of Kaiser Permanente Northern California. The study suggests that those who use the mail-in system may take the drugs more regularly.
Of new statin users identified between 2005 and 2007, twenty-nine percent used a mail-order pharmacy at least once to refill their medication. That group was more likely to be white and of a higher socioeconomic status. But when researchers used statistical analysis to control for demographic differences, they found that 85 percent of those patients hit their target cholesterol levels during follow-up tests at least three months after they started the drugs. Of the group that used a walk-in pharmacy, 74 percent hit the target levels.
The researchers suggest that promoting more mail-order refills could be a cost-effective way of reducing risk of cardiovascular disease.
BOTTOM LINE: People who get their statin prescriptions filled through the mail may control their cholesterol levels better than people who use local pharmacies.
CAUTIONS: The observational study looked only at patients using the Kaiser Permanente mail order system and pharmacies.
WHERE TO FIND IT: Journal of General Internal Medicine, July 2011
Skin screenings by doctors may find melanoma earlier Dermatologists often recommend that patients regularly examine their skin for potentially cancerous lesions. But the US Preventive Services Task Force determined in 2009 that there was not enough evidence to recommend regular screenings by a physician.
In an effort to test the effectiveness of doctor screenings, researchers from Memorial Sloan-Kettering Cancer Center in New York performed a retrospective review of 10 years of patient records at a lesion clinic there. They found 527 melanomas in 394 patients, and they compared the frequency and severity of lesions found in new patients with those found in established patients, who had been seen by a dermatologist for at least three months.
They found that 76 percent of 494 primary melanomas were detected by a dermatologist. Ninety-one were found by the patient. The remainder were discovered by another physician. Melanomas found among established patients were less invasive and more likely to be identified in a precancerous stage.
The authors said the results support the promotion of both self-examination and physician screening.
BOTTOM LINE: Physician skin screenings could result in the earlier detection of melanoma.
CAUTIONS: The study looked at data retrospectively and focused on patients in a referral center not representative of the general population. The authors also did not look at patient survival.
WHERE TO FIND IT: Archives of Dermatology, online July 18
CHELSEA CONABOY
Chelsea Conaboy can be reached at cconaboy@boston.com. 
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