A novel evidence-based medicine approach for determining aetiology of side effects with statins
File(s)
Author(s)
Wood, Frances
Type
Thesis
Abstract
Statins are a proven highly effective way to prevent and manage cardiovascular disease. Adherence to cardiovascular prevention medication, including statins, is poor and results in morbidity, mortality and increased healthcare costs. Side effects are often a cause for stopping statins in clinical practice despite there being equivalent rates of side effects between statins and placebo tablets in randomised blinded control trials. The Self-Assessment Method for statin side effects Or Nocebo (SAMSON) developed a phone application to allow participants to test for themselves in a randomised controlled trial whether statins side effects were greater when taking a statin compared to a placebo and also compared tablet periods to no treatment periods. The results demonstrated there was no significant difference between statin or placebo months but there was a significant difference between tablets and no tablet months. What is more, after being given their personal trial results 50% of participants restarted a statin. The results offer a potential intervention to help patients restart statins which are a drug indicated for various disease conditions not just for cardiovascular disease. This type of intervention also has potential utility in other types of drug classes where nocebo is an issue. Furthermore, the research reflects on individual experiences of statins and finds that although there is trust in medical professionals there is a lot of counter-information about statins that can make patients unsure what information is accurate. This thesis raises an important questions about whether patients knowing about the nocebo effect might help them to be less likely to fall foul of it. In light of the findings of this thesis, current management of suspected side effects with statins might not be effective or even counterproductive and review of existing guidelines in light of the results of this thesis are recommended.
Version
Open Access
Date Issued
2021-06
Date Awarded
2021-10
Copyright Statement
Creative Commons Attribution NonCommercial Licence
License URL
Advisor
Francis, Darrel
Thom, Simon
Norton, Christine
Shun-Shin, Matthew
Sponsor
Imperial College London
Grant Number
PG/15/7131235
Publisher Department
National Heart & Lung Institute
Publisher Institution
Imperial College London
Qualification Level
Doctoral
Qualification Name
Doctor of Philosophy (PhD)