Thursday 27 January 2011

More harm than good?

‘Are statins effective for the millions of people who take them?’ asked the BBC last week in response to recent research findings proposed by the London School of Hygiene and Tropical Medicine. The Daily Telegraph website claims that millions of patients are taking statins 'needlessly', with an apparently greater potential to experience more harm than good. Whilst talking to an older relative prescribed Simvastatin for primary prevention during the week, my opinion on the matter was asked.

A collection of evidence based medicine, lipid lowering drugs, research skills critical appraisal and patient counselling lectures sprung vaguely to mind. After the briefest of conversations with my housemate and fellow third year pharmacy student, I came to the earth shattering conclusion ‘it’s probably fine’. But when isn’t this sort of thing a somewhat grey area? If there’s such a thing as exact science I doubt we’ll find it when weighing up the risks/benefits of using statins for primary prevention.

After attending a workshop on cardiovascular risk assessment this week, I told my aforementioned relative to check out two equally crude cardiovascular risk calculators online. Have a look yourself (try http://www.qrisk.org or http://www.patient.co.uk/doctor/Primary-Cardiovascular-Risk-Calculator.htm ), or play with the epic smiley face patient decision aid tools found here http://www.nntonline.net/visualrx/examples/statins/ .

I can’t face delving into hard facts and numbers to investigate the matter further. However, I did scroll down the heated (by no means representative) barrage of online responses to the Telegraph’s slightly sensationalist take on things. It's clear that media attention of this nature has a direct implication for pharmacy practice. Patients have concerns, and generally want to know what’s going into their bodies and why. Patients need to be assured that healthcare professionals care about the outcome of drug therapy from every day patient perspectives.

We should be ready to address seriously all of the worries patients have about side effects and any long term risks that arise. The more we encourage patients to get involved in decisions about their care, the less likely people will be asking questions like ‘Are all the profs doing statin research working at Norwich Uni and hiding all the evidence?’. Genuine,quote of the day. As future pharmacists and healthcare professionals generally, we need to take some responsibility for helping patients and the public become better aware of medicine and healthcare issues relating to them, benefits, risks and all.

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