Side Effect Risk Could Be Preventing Stroke Patients from Taking Statins

Researchers in the UK have found that stroke survivors may not be taking their statin medicines as prescribed over concerns about potential side effects associated with the drugs. According to patients’ own reports about why they stopped taking the cholesterol-lowering drugs, recent media coverage highlighting the side effects – including increased risk of developing diabetes and liver damage – exacerbated the medication adherence issue.

Once a person suffers a stroke, they are at risk of a recurrence, which also increases their odds of mortality. To mitigate this risk, stroke survivors are often prescribed statins and other preventative medications, however about one third of patients don’t follow their prescribed medication schedule.

By analyzing posts on the Stoke Association’s forum TalkStroke, researchers at the University of Cambridge and Queen Mary University, London (QMUL) sought to determine what reasons patients and their caregivers had for not taking their post-stroke medications as prescribed. The study spanned a seven-year period, from 2004 to 2011, with both patients who had a stroke and their caregivers posting on the site.

The researchers used a number of keywords – including ‘taking medication,’ ‘pills,’ and ‘side-effects’ – to find relevant posts for this medication adherence study. In all, they identified 84 posts submitted by participants, including 49 from stroke patients and 33 from their caregivers. The researchers published their analysis of those posts in the journal, BMJ Open.

The UK team found that side effects of medications were cited as one of the main contributors to a stroke survivor’s decision to stop taking the drugs. While some patients referred to the negative side effects they themselves experienced while taking statins, others made the decision to cease taking the drugs after reading about the potential side effects in the news.

“These findings have highlighted the need for an open, honest dialogue between patients and/or their carers, and healthcare professionals,” said senior study author Dr. Anna De Simoni, a lecturer in Primary Care Research at QMUL and visiting researcher at the Department of Public Health and Primary Care, University of Cambridge. “Doctors need to listen to these concerns, discuss the benefits and drawbacks of taking the medication, and be willing to support a patient’s informed decision to refuse medications.”

Forum users also cited difficulties in swallowing large pills and complex drug regimens as reasons why they stopped taking their medication. The research highlights the importance of doctors’ willingness to work with patients to make medication adherence as convenient as possible for them.

“By analyzing people’s views as expressed in online forums, where they are more open and less guarded, we’ve seen some valuable insights into why some stroke survivors have difficulty adhering to their medication,” said first author James Jamison, PhD candidate from the Department of Public Health and Primary Care at Cambridge. “Challenging negative beliefs about medication and adopting practices that make routines for taking medication simpler, particularly for those patients who have suffered disability as a result of stroke, should increase adherence and ultimately improve health outcomes.”