Patient-Reported Reasons for Switching or Discontinuing Statin Therapy: A Mixed Methods Study Using Social Media

Abstract

Introduction Statin discontinuation can have major negative health consequences. Studying the reasons for discontinuation can be challenging as traditional data collection methods have limitations. We propose an alternative approach using social media. Methods We used natural language processing and machine learning to extract mentions of discontinuation of statin therapy from an online health forum, WebMD ( http://www.webmd.com ). We then extracted data according to themes and identified key attributes of the people posting for themselves. Results We identified 2121 statin reviews that contained information on discontinuing at least one named statin. Sixty percent of people posting declared themselves as female and the most common age category was 55–64 years. Over half the people taking statins did so for < 6 months. By far the most common reason given (90%) was patient experience of adverse events, the most common of which were musculoskeletal and connective tissue disorders. The rank order of adverse events reported in WebMD was largely consistent with those reported to regulatory agencies in the US and UK. Data were available on age, sex, duration of statin use, and, in some instances, adverse event resolution and rechallenge. In some instances, details were presented on resolution of the adverse event and rechallenge. Conclusion Social media may provide data on the reasons for switching or discontinuation of a medication, as well as unique patient perspectives that may influence continuation of a medication. This information source may provide unique data for novel interventions to reduce medication discontinuation. Supplementary Information The online version contains supplementary material available at 10.1007/s40264-022-01212-0.

Artificial Intelligence–Enabled Analysis of Statin-Related Topics and Sentiments on Social Media

“…Registry have identified patient perceptions and barriers to statin adherence. 6,7,33,34 The present study corroborated some of these previous findings, uncovering similar reasons for statin hesitancy, Because no topics had a positive sentiment, the color map was truncated at 0.2 to allow for differentiation between negative and neutral sentiments. 36 Such misperceptions posted on social media platforms can serve as seeds for the spread of misinformation.…”

“…For example, the USAGE (Understanding Statin Use in America and Gaps in Patient Education) study and PALM (Patient and Provider Assessment of Lipid Management) Registry have identified patient perceptions and barriers to statin adherence. 6 , 7 , 33 , 34 The present study corroborated some of these previous findings, uncovering similar reasons for statin hesitancy, including adverse effect profiles (eg, myalgias, increased risk of diabetes, and cognitive dysfunction; group 2), disbelief in the LDL-C hypothesis, preference for lifestyle alternatives (eg, dietary or supplementary modifications; groups 1, 3, and 6), and general disenfranchisement with health care (group 5). Furthermore, novel points of discourse were uncovered, such as the role of statins in improving COVID-19 outcomes, controversy regarding lifestyle improvement on a ketogenic diet but developing asymptomatic dyslipidemia, the use of the coronary artery calcium score as a convincing data point for initiating a statin, and hesitancy toward statins because of concerns that statins were made with fetal stem cells.…”

“…The primary groups of discussion in this study align with findings in prior studies that assessed patient beliefs about statins. For example, the USAGE (Understanding Statin Use in America and Gaps in Patient Education) study and PALM (Patient and Provider Assessment of Lipid Management) Registry have identified patient perceptions and barriers to statin adherence . The present study corroborated some of these previous findings, uncovering similar reasons for statin hesitancy, including adverse effect profiles (eg, myalgias, increased risk of diabetes, and cognitive dysfunction; group 2), disbelief in the LDL-C hypothesis, preference for lifestyle alternatives (eg, dietary or supplementary modifications; groups 1, 3, and 6), and general disenfranchisement with health care (group 5).…”

Year 2022 in Medical Natural Language Processing: Availability of Language Models as a Step in the Democratization of NLP in the Biomedical Area

“…• when other sources of information are not freely available, such as in languages other than English [7,9,19,20,22,38,43,47]; • when researchers investigate questions related to patients and population, while these questions are not discussed with medical doctors or require large population samples. We can mention for instance sentiment analysis on medication and vaccines [7,20,33,38,43,47], and adverse drug effects [76,77]; • when mental health of patients is concerned in cases like depression [9, 4, 78], eating disorders [79], suicide detection and prevention [19,80], quality of life of patients [31,81], and drug misuse [82][83][84].…”

Angiotensin-converting enzyme inhibitors, statins and the polypill in cardiovascular diseases prevention: ignorance is bliss or not?

“…Medication nonadherence/discontinuation is an important issue in healthcare worldwide and it is a particular challenge for the treatment of chronic diseases. In the last few years, the role of social media in delivering patients personal experience following drug administration is becoming of great importance since it might influence other patients adherence to medical therapy [7]. Medication nonadherence/discontinuation may result in significant increase in adverse events and healthcare cost [7].…”