London School of Hygiene & Tropical Medicine

From climate change and GM foods, to saturated fats and vitamin supplements, academic debates played out through the media are nothing new. The UK is fortunate to have so many excellent health and science reporters, and we know their stories can communicate important health messages and have the power to influence the public. However, what is less clear is how much of an impact high profile health stories can have on public health.

The use of statins is one of the hottest topics in pharmaceutical healthcare today. The drugs reduce the risk of cardiovascular disease (CVD) and, in the UK, are widely recommended as part of the prevention strategy for patients who are most at risk of a cardiovascular event such as a heart attack or stroke, or who have recently experienced one.

Severe side effects associated with statins are extremely rare, but questions over the frequency with which the drugs cause problematic symptoms, such as muscle pain and weakness, have been raised in the academic press and reported in the national media. The School has just begun a major new trial to further our understanding of this link.

From October 2013 to March 2014 there was a period of intense media coverage about statins. This likely stemmed from:

• Two articles published in the British Medical Journal which were perceived as critical of statins, one of which questioned whether their benefits outweighed their side effects for intermediate risk patients.

• Impending changes in the guidelines proposed by the UK’s National Institute for Health and Care Excellence (NICE, July 2014), which broadened eligibility for statins from patients with high CVD risk to those with intermediate ten year CVD risk.

• Public disagreements between some doctors and academics about both the extent to which statins caused problematic side effects, and the wisdom of loosening the criteria for recommending statins.

Colleagues and I examined whether the media coverage reflecting this debate could affect the use of statins. There was no evidence that widespread media coverage of the debate was linked to changes in the proportion of newly eligible patients starting statins, but there was an increase in existing users stopping statin therapy. The increase appeared to be temporary, with the overall proportion stopping the drug returning to expected levels six months after the coverage.

We scaled up our findings and found that the media coverage could have resulted in more than 200,000 patients across the UK stopping statin therapy in the six months following the exposure period.

It appears, then, that widespread coverage in the mainstream media can impact on the behaviour of patients and doctors. Other health-related stories covered by the media have shown similar knock-on effects, and not just negative ones. Several studies have shown marked increases in people coming in for cancer screening after media coverage of celebrities such as Kylie Minogue developing cancer.

A note of caution. Our statins research was an observational study using data from UK primary care records. We did not ask patients why they stopped statins so we can’t say for sure that media coverage was the cause of the increase. However, additional analyses strengthen our confidence in the findings.

Importantly, the scientific consensus on the benefits of statins has not changed, but it does appear that public confidence was dented 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.

So who is to blame?  There is a concern that widespread reporting of the debate giving disproportionate weight to a minority view about possible side effects could have been the catalyst for the increase in people stopping their statin. However, journalists face a tough task in reporting claims and counter claims when it comes to health research, something the academic world needs to be more aware of.

Media is the last link in the chain. Scientists, academic journals and press offices have a responsibility to accurately disseminate research and help people to make informed choices. Good public health is in everyone’s best interest.

Image: Pills and bottles. Credit: Freeimages.