Statins debate may have caused temporary slump in use

Controversy over the risks and benefits of statins led to more than 200,000 UK patients putting their health at risk by temporarily halting use of the preventative drugs. Picture: TSPL

Statins are used to prevent heart disease but concerns over extending their use to healthy people with a low risk of cardiovascular illness sparked an intense public debate in 2013-14.

Researchers from the London School of Hygiene and Tropic Medicine examined prescribing data from GPs to uncover how the public debate impacted on patients with existing heart disease and those at risk of developing the disease starting and stopping statins.

The authors estimate that more than 200,000 patients across the UK may have stopped statin therapy in the six months after, which could lead to more than 2,000 additional cardiovascular events, such as heart attacks and strokes, over the next 10 years.

Patients already taking statins were more likely to stop taking them for both primary and secondary prevention after the period of high media coverage, particularly older patients and those with a longer continuous prescription.

Lead author Professor Liam Smeeth said: “It’s undoubtedly important that these debates are reflected in the media, who play a key role in communicating public health advice, but there is a concern that in the case of statins, widespread reporting of the debate may have given disproportionate weight to a minority view about possible side effects, denting public confidence in a drug which most scientists and health professionals believe to be a safe and effective option against heart disease for the vast majority of patients.”

There was no evidence that newly eligible patients were put off starting statins after the controversy, the research published in the British Medical Journal found.

The results are observational but the authors say they highlight “the potential for widely covered health stories in the lay media to impact on healthcare related behaviour.”

Writing in a linked editorial Gary Schwitzer, Publisher of HealthNewsReview.org, said the authors provide no patient data to support the belief that people stopped because of news reports, nor did they explore whether there were reduced side effects, such as muscle pain and diabetes, as a result of stopping.

Professor Peter Weissberg, medical director at the British Heart Foundation (BHF), said: “There is no debate that patients who have suffered a heart attack or stroke should be taking statins to reduce their risk of another cardiovascular event.

“Evidence from numerous objective clinical trials also shows that statins are a safe and effective way of reducing risk of someone suffering a heart attack or stroke in the first place.

“It is absolutely vital that medical practice is guided by evidence, rather than strongly held personal opinions.”

A separate study suggested that some GPs lack confidence when responding to patients’ concerns about statins.

The research, conducted by the Picker Institute on behalf of the BHF, conducted three focus groups with GPs as well as an online poll of family doctors and cardiologists.

The authors wrote: “GPs in the focus groups reported a lack of confidence when responding to patients’ concerns about statins. They emphasized that they were generalists, not specialists, and that they struggled to keep up to date on the constantly changing landscape of research on the wide range of conditions relevant to their patient populations, particularly around complex issues such as statins.”

But 37 per cent of the 625 GPs who responded to the online poll said they were “very confident” in understanding the risks and benefits of statins, three in five said they were “fairly confident”, and 3 per cent said they were not confident.