In an editorial, a group of doctors call for “shared decision making” with patients about whether or not to take statins.
Patients should be given more information about statins and told it is safe to stop using them if they suffer side effects, a group of doctors have said.
Writing in a medical journal, they highlight studies showing that the drugs save around 1 life for every 200 people taking them, and advice from manufacturers that up to 1 in 10 people can suffer some side effects.
The doctors call for more “shared decision making” between doctors and patients, who should be told they can “safely” stop using them if they experience unwanted effects, in an editorial for UK medical journal Prescriber.
The call comes from Dr Aseem Malhotra, honorary consultant cardiologist Frimley Park Hospital, in Surrey, Professor James McCormack, professor at the Faculty of Pharmaceutical Sciences, Vancouver, and Professor David Newman, director of clinical research at Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York.
They say that for healthy people who have never had a heart attack or stroke, statins have limited benefits.
“Less than 1 in every 200 people who took a statin lived longer because of it,” they write, highlighting studies which show that even among those with a history of heart disease or stroke, the figure is 1 per cent.
Patients should be better educated on the on the impact of changing their diet, exercise and smoking, says the group, which says doctors should pay more attention to individual preferences when prescribing medicines instead of relying on treatment targets.
Current guidance from the National Institute for Health and Care Excellence advises GPs to consider statins if their patient has a 20 per cent risk of developing cardiovascular disease within 10 years.
Information published by drug manufacturers suggests that up to one in 10 patients can suffer from effects including sore throats, nausea, digestive problems, muscle and joint pain when taking the drugs.
Dr Chaand Nagpaul, Chair of the BMA’s GP committee, said doctors needed to pay more attention to the preferences of each patient.
“We should not make treatment dependent on crude thresholds that handle patients in a cold statistical manner,” he said.
“Any decision on treatment should look at wider factors, including lifestyle, and empower patients to make informed choices about their own healthcare choices. Giving the public long enough with their GP during an appointment is a key factor in ensuring strong joint decision making between clinician and patient.”
Other experts defended the current approach, saying targets help to guide GPs.
Dr Tim Chico, reader in cardiovascular medicine and consultant cardiologist at the University of Sheffield, said: “I completely disagree that treatment targets remove individual preference. These targets simply guide doctors as to which patients might benefit from a treatment.
“The decision whether to start or continue a drug treatment should always rest with the patient, with this decision guided by information from the doctor.”
He added: “This editorial seems to want to present a false choice between drug treatment or lifestyle factors such as diet, when both are important.”
Previous research earlier this year said the cheap drugs, which cost just a few pence per day, could also reduce deaths from cancer.
Sir Richard Thompson, former president of the Royal College of Physicians, said: “This editorial offers a timely reminder that it is not easy to discover how patients weigh the benefits of a medication against its risks.
“Setting a threshold for treatment based on the results of clinical trials further unbalances how doctors and patients discuss how to choose between a drug therapy or an alternative treatment.”