Friday 19 August 2011

Iatrogenesis


It is now four years since Dr Malcolm Kendrick published his book questioning the wholesale prescribing of statins to asymptomatic and low risk patients. He has been mainly ignored by the mainstream medical establishment and statins are now taken by nearly 7 million people in the UK. I personally have seen patients who have been started on statins in their 70s and 80s, having never had a cardiovascular event. What are their doctors thinking? 

There seems to be little acknowledgement that these drugs can have serious and unpleasant side effects and in people who have no history, no symptoms and little risk, starting these drugs on the basis of numbers on a lab report is very poor medicine. Inducing side effects in these people is unforgivable, and persuading these patients that the drugs are giving significant benefit is dishonest and insupportable.

Yet more evidence is now emerging that supports Dr Kendrick’s view. How long is it going to be before the medical profession takes notice?

And as for the polypill, not yet adopted by doctors, this concept should be strangled at birth.

5 comments:

  1. the a&e charge nurse19 August 2011 at 10:31

    According to Kendrick not even the most rudimentary elements of the cholestrol hypothesis stack up - his book joins a growing number of authorities who look on aghast while statins are doled with even greater frequency than antibiotics and SSRIs (if such a thing is possible).
    http://www.youtube.com/watch?v=XPPYaVcXo1I

    Proof, if proof were needed that clever people can be persuaded to do stupid things once there is sufficient momentum?

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  2. Hyperbole often transcends scientific fact and the indefensible, is defended with vigour, including the denunciation of that which is patently true. Your profession all too often wants only to hear that which is comforting, reinforces preconceptions, and is non-disruptive. Having your beliefs undermined seems too difficult to be accepted by Medic's despite the huge wieght of evidence, that outcomes for all cohorts on statins including those with previous CHD/CVD events is minimal to none and for those with no previous history and all women is, well none.

    We also have to factor in Pharma's huge sales from this product which for Lipitor alone is $11 billion per year. Oh and of course the QOF for GP's. We really are are pushing a rock up hill to change the paradigm. Having been told by a GP at my surgery (young and new) that if eat fat it will 'clog' my arteries, it surprises me not that 'science' at grass roots level, is an alien concept.

    As for the 'polypill', well perhaps strangling Prof's Law and Wald, might be a better plan.

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  3. Friend of mine ( with 6 doctors in her family) went on STATIN because she is mildly diabetic. Developed double vision & it was me that pointed her to some papers about the STATINS and vision. 8 weeks later, all cleared.

    (December 2008 issue of Ophthalmology)
    Good one.

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  4. Poor GPs. We are harangued by punters who come in demanding to know "what their cholesterol is" having seen the Florid Poo Activ adverts. Also the Daily Wail health secdtion - though I think statins are currently a cause of cancer.
    My punters get quite frustrated when I refuse to give top line total cholesterol levels out over the 'phone (I will only quote LDL:HDL ratios) or even refuse to test at all in someone who's had a normal reading in the past. It's a battle I wage on a daily basis :-(

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  5. the a&e charge nurse25 August 2011 at 11:05

    According to NNT 98% without heart disease saw no benefit from taking a statin
    http://www.thennt.com/statins-for-heart-disease-prevention-without-prior-heart-disease/

    And 96% with heart disease saw no benefit after taking a statin for 5 years
    http://www.thennt.com/statins-for-heart-disease-prevention-with-known-heart-disease/

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