Matthews Anthony, Herrett Emily, Gasparrini Antonio, Van Staa Tjeerd, Goldacre Ben, Smeeth Liam, Bhaskaran Krishnan
Department of Non-Communicable Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK.
BMJ. 2016 Jun 28;353:i3283. doi: 10.1136/bmj.i3283.
To quantify how a period of intense media coverage of controversy over the risk:benefit balance of statins affected their use.
Interrupted time series analysis of prospectively collected electronic data from primary care.
Clinical Practice Research Datalink (CPRD) in the United Kingdom.
Patients newly eligible for or currently taking statins for primary and secondary cardiovascular disease prevention in each month in January 2011-March 2015.
Adjusted odds ratios for starting/stopping taking statins after the media coverage (October 2013-March 2014).
There was no evidence that the period of high media coverage was associated with changes in statin initiation among patients with a high recorded risk score for cardiovascular disease (primary prevention) or a recent cardiovascular event (secondary prevention) (odds ratio 0.99 (95% confidence interval 0.87 to 1.13; P=0.92) and 1.04 (0.92 to 1.18; P=0.54), respectively), though there was a decrease in the overall proportion of patients with a recorded risk score. Patients already taking statins were more likely to stop taking them for both primary and secondary prevention after the high media coverage period (1.11 (1.05 to 1.18; P<0.001) and 1.12 (1.04 to 1.21; P=0.003), respectively). Stratified analyses showed that older patients and those with a longer continuous prescription were more likely to stop taking statins after the media coverage. In post hoc analyses, the increased rates of cessation were no longer observed after six months.
A period of intense public discussion over the risks:benefit balance of statins, covered widely in the media, was followed by a transient rise in the proportion of people who stopped taking statins. This research highlights the potential for widely covered health stories in the lay media to impact on healthcare related behaviour.
量化一段时期内媒体对他汀类药物风险效益平衡争议的密集报道对其使用的影响。
对前瞻性收集的基层医疗电子数据进行中断时间序列分析。
英国临床实践研究数据链（CPRD）。
2011年1月至2015年3月期间每月新符合条件或正在服用他汀类药物进行一级和二级心血管疾病预防的患者。
媒体报道（2013年10月至2014年3月）后开始/停止服用他汀类药物的调整比值比。
没有证据表明媒体高度报道期与心血管疾病记录风险评分高（一级预防）或近期心血管事件（二级预防）患者的他汀类药物起始使用变化有关（比值比分别为0.99（95%置信区间0.87至1.13；P=0.92）和1.04（0.92至1.18；P=0.54）），尽管记录风险评分患者的总体比例有所下降。在媒体高度报道期后，已经服用他汀类药物的患者更有可能因一级和二级预防而停止服用（分别为1.11（1.05至1.18；P<0.001）和1.12（1.04至1.21；P=0.003））。分层分析表明，老年患者和连续处方时间较长的患者在媒体报道后更有可能停止服用他汀类药物。在事后分析中，六个月后不再观察到停药率增加。
媒体广泛报道的一段时期内公众对他汀类药物风险效益平衡的激烈讨论之后，停止服用他汀类药物的人群比例短暂上升。这项研究凸显了大众媒体广泛报道的健康事件对医疗相关行为产生影响的可能性。
