Editors Notes: ( Ralph Turchiano) Two articles are posted here the first one explaining the validity of the study. The second how ABC was pressured to withdraw the episodes in regards to the valid study.
Australians cut back on or stopped taking statins following ABC Catalyst story, researchers find
By medical reporter Sophie Scott
Updated about an hour ago
More than 60,000 Australians cut back on or stopped taking cholesterol-lowering drugs known as statins after a program questioning their effectiveness aired on Australian TV, researchers have estimated.
University of Sydney researchers found an immediate impact after the science program Catalyst aired on the ABC in October 2013.
Researchers looked at the Pharmaceutical Benefits Scheme medication records of 191,000 people and found 14,000 fewer people dispensing statins per week than expected.
Their work was published in the Medical Journal of Australia.
Researchers said an estimated 60,897 fewer people filled their statins prescriptions in the eight months following the Catalyst broadcast.
They said this could result “in between 1,522 and 2,900 preventable, and potentially fatal, heart attacks and strokes”.
Media player: “Space” to play, “M” to mute, “left” and “right” to seek.
The Catalyst program examined the importance of cholesterol in cardiovascular disease and the appropriate use of statin medication.
A spokesman for the ABC said the network acknowledged problems with the program Heart of the Matter and removed it from iview.
“The ABC notes that the Medical Journal report acknowledges that the use and overuse of statins is a legitimate public health policy issue,” he said.
“As was stated in the program and restated on the Catalyst website, viewers should not make any changes to their prescribed regimen of medications without seeking appropriate medical advice.”
Lead author Andrea Schaffer, from the University of Sydney’s Faculty of Pharmacy, said some patients at higher risk of cardiovascular disease, such as those taking medication for diabetes, stopped taking statins.
“We found even in this group [who were dispensed diabetes medications], who were known to be at high risk of cardiovascular disease, there was a reduction in statin use in this group,” she said.
Debate over appropriate use of statins
The National Prescribing Service said evidence from a large review of clinical trials in people at high risk had shown statin medicines could substantially lower the chance of having a major cardiovascular event, on average by about 20 per cent.
Cholesterol-lowering statins explained
They said statins could help prevent heart attacks and strokes in people who had already had one and were at high risk of another.
But there has been debate about whether it is appropriate to use the medications in healthy people with low risk of a heart attack or stroke.
The Royal Australian College of General Practitioners (RACGP) recently recommended patients talk to their doctors about whether statins are appropriate.
The RACGP said doctors should not commence therapy for high cholesterol or high blood pressure without assessing the absolute risk of a cardiovascular event like a heart attack or stroke.
The American Heart Association said taking a statin was now recommended for:
- Anyone who has cardiovascular disease, including angina, a previous heart attack or stroke, or other related condition
- Anyone with a very high level of harmful LDL cholesterol
- Anyone with diabetes between the ages of 40 and 75 years
- Anyone with a greater than 7.5 per cent chance of having a heart attack or stroke or developing other forms of cardiovascular disease in the next 10 years.
Statins ‘overused’ in low risk population
An analysis of Pharmaceutical Benefits Scheme data published earlier this year by Australian Doctor showed no drop in statin prescribing rates.
The medical publication said dispensing of the top three statins held steady in the three months after the Catalyst program was aired and rates increased slightly from 1.4 million in November 2013 to 1.5 million in January 2014.
But some doctors strongly believe statins are being over-prescribed.
Harvard professor John Abramson has written a number of scientific papers raising concerns about the overuse of the cholesterol-lowering drugs.
He raised queries about the latest research in the Medical Journal of Australia and said the risk level of those who discontinued the statin medication was not known.
“By the article’s own admission statins are overused in what the Australian guidelines call a low risk population — less than 10 per cent five-year risk,” he said.
“The article’s assertion that the discontinuations could result in between 1,522 and 2,900 preventable, and potentially fatal, major vascular events is based on false premises.
Public Release: 14-Jun-2015
Power of the media’s impact on medicine use revealed
How ABC TV’s Catalyst changed patients’ use of statins
University of Sydney
More than 60,000 Australians are estimated to have reduced or discontinued their use of prescribed cholesterol-lowering statin medications following the airing of a two-part series critical of statins by ABC TV’s science program, Catalyst, a University of Sydney study reveals in the latest Medical Journal of Australia.
The analysis of the Pharmaceutical Benefits Scheme medication records of 191,000 people revealed that there was an immediate impact after Catalyst was aired in October 2013, with 14,000 fewer people dispensed statins per week than expected.
“In the eight months following the Catalyst broadcast, an estimated 60,897 fewer people had statins dispensed than expected. If patients continue to avoid statins over the next five years, this could result in between 1,522 and 2,900 preventable, and potentially fatal, heart attacks and strokes,” the authors report.
The Catalyst program questioned the link between cholesterol and heart disease and suggested that the benefit of statins for preventing cardiovascular disease had been exaggerated.
Statins are widely used drugs recommended nationally and internationally to prevent and manage the risk of cardiovascular events such as heart attacks and strokes, in people at risk of cardiovascular disease. Following the broadcasts, health experts, including ABC presenter Dr Norman Swan, were highly critical of the program for misrepresenting scientific evidence and scaring people away from prescribed medications.
The ABC subsequently removed the episodes from the Catalyst website after an internal review found that the episodes on statins had breached its impartiality standards.
Lead author, Andrea Schaffer from the University of Sydney’s Faculty of Pharmacy, stated: “The impact of the program was not only immediate, but long-lasting. Statin dispensings were significantly lower than expected for the entire 8-month post-broadcast period we examined. It is unclear how long this change will last.”
“What is particularly concerning is that this drop in statin use was seen in people who were at high risk of cardiovascular disease – for example, those who were also taking medications for diabetes,” said Associate Professor Sallie Parson, senior author on the study and Scientific Director of the Centre of Research Excellence in Medicines and Ageing.
“Heart attacks and strokes are the main killers of people with diabetes. Statins are recommended for people at high risk of cardiovascular disease because they have been shown to be effective. However, like all medications, they have risks and benefits and should only be used as recommended.”
The authors of the MJA paper said that even though the observed effect was relatively small, the prevalence of statin use in Australia and their established efficacy means that a large number of people are affected, and may suffer unnecessary consequences.
Early warning: concerns were raised prior to the airing of the Catalyst program on statins
Prior to the airing of the Catalyst episode on statins, ANU Professor Emily Banks – a co-author of the new MJA study – raised concerns that the program could have adverse health impacts.
“The media has a critical role to play in questioning the status quo and in helping people to make sense of health information. These findings demonstrate the power of the media and how serious the consequences can be if reporting is not balanced and informed.” She stated: “The ABC should be praised for facilitating dialogue about concerns raised by the program and for withdrawing the program when it was found to have breached their standards.”
NPS MedicineWise, which provides guidance to health professionals and consumers on medicines, highlighted the importance of reliable information on medicines for health professionals and consumers.
“At the time the Catalyst program went to air, we expressed concern that people prescribed statins may stop taking their medicine without talking to a health professional,” said NPS MedicineWise CEO, Dr Lynn Weekes. “In light of the findings of this study, we would like to re-emphasise how important it is to have a conversation with your doctor before making decisions about your prescription medicines.”
The CEO of the Consumers Health Forum, Leanne Wells, said, “this study highlights the hazards for consumers of accepting media stories on medicine and applying them unquestioningly to their own health care.
“It is a timely warning to the very many people who may depend on the internet and the mass media to guide their medical care. The statins story was particularly problematic because of the millions of Australians who need to take this medication daily.
“As we said at the time, patients should consult their doctor before stopping their medication. Consumers need balanced information about medicines and their health,” Ms Wells said.
Fast facts about the study
- Study design: Interrupted time series with control group
- Study period: July 2009 to June 2014
- Sample size: 191,833 people
- Average age: 72 years
- Gender: 55 per cent female
The research was funded by the National Health and Medical Research Council (NHMRC) Centre of Research Excellence (CRE) in Medicines in Ageing.
Andrea Schaffer has received the Stanley A. Edlavitch Award for the Best Student Abstract submitted for the 31st International Conference on Pharmacoepidemiology & Therapeutic Risk Management for this research. She will receive this award and present her findings at the ICPE meeting in Boston in August 2015.