Abstract
Statins are prescribed to help lower cholesterol levels but have poor adherence rates. Attitudes or beliefs toward medications are important to ascertain because they may be associated with patient behavior. To identify health-related discussion in Twitter posts mentioning a statin and analyze the content within these posts. This qualitative study included 11 852 posts related to 1 of 8 statins (7 licensed for use in the United States and 5 licensed in the United Kingdom) collected from May 10, 2013, to August 28, 2018. Twitter posts were identified as health related or not, and if health related, whether they were posted by a statin user, someone who knows a statin user, a health care professional, or undetermined. The health-related tweets were classified by the type of information posted, such as a belief about the medication, an adverse event, a question, or a reference to the cost of the medication. Data were analyzed from January 22 to November 19, 2019. The number of posts by each user type identified and the categories identified by analyzing the content. Of the 11 852 Twitter posts about statins, 5201 (43.9%) were health related. The most frequent posts provided resource information, such as a link to a journal article (1824 of 5201 [35.1%]). The second most frequent type of health-related posts included personal beliefs or attitudes toward statins (1097 of 5201 [21.1%]). Personal experiences of adverse events (353 of 5201 [6.8%]), discussions about dosage (320 of 5201 [6.2%]), and questions about statins (191 of 5201 [3.7%]) followed. Posts indicated polarized beliefs and attitudes to statins from saving lives to causing death. Some beliefs, such as the direct confirmation that the use of statins mitigates the effects of an unhealthy diet, have not been extensively highlighted as common practice in the literature. This qualitative content analysis of Twitter posts about statins provides insights into beliefs about statins. Patient perspectives gathered from social media may help to inform research and improve public health messages and communication between health care professionals and patients.
Highlights
Statins are one of the most frequently prescribed, cost-effective agents to decrease cholesterol levels.[1]
Posts indicated polarized beliefs and attitudes to statins from saving lives to causing death. Some beliefs, such as the direct confirmation that the use of statins mitigates the effects of an unhealthy diet, have not been extensively highlighted as common practice in the literature
We excluded 748 posts not related to statins, 31 computer-generated posts, and 18 in a non-English language
Summary
Statins are one of the most frequently prescribed, cost-effective agents to decrease cholesterol levels.[1]. Guidelines on cardiovascular disease prevention recommend lifestyle changes alone or in addition to statins.[6,7] Determinants of patient behavior, including medication adherence and lifestyle, are related to patient experience and attitudes and opinions about the medication.[3,8,9,10] These determinants include adverse reactions,[11] cost, and beliefs.[12,13,14,15] Negative beliefs about a medication (such as fear of dependence) pose a stronger deterrent to adherence than other barriers, such as costs,[16] and attempting to reduce copayments for cardiovascular drugs is largely ineffective.[17]
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