How do people decide whether to take medicines?

Professor Sir John Tooke discusses the importance of communicating evidence for medicines and health advice.

Deciding whether or not to take a medicine is a complex decision. It is not based only on healthcare professionals' advice, but also a person’s own health beliefs and their interpretation of available information and opinion.

Increasingly such information comes from a range of sources beyond the prescribing doctor, including the media, social media, and friends and family.

A study in the BMJ¹, published this week, has shown that a period of controversial media coverage about the side effects of statins' adversely impacted on the number of people taking the medication.

Clearly communicating evidence for medicines and health advice is important and not doing it well can have serious repercussions for individuals and the wider public.

However, what comes out of this study should not be a criticism of the media. It should instead be a reminder for medical scientists and healthcare professionals that, together with the media, we have a shared responsibility to ensure the information the public receives is reliable, accessible, and most importantly represents the best evidence available.

The Academy has recognised this as a crucial aspect to address in its project 'How can we all best use evidence to judge the potential benefits and harms of medicines', and it has formed the basis of one of three sub-projects.

As part of the ‘Communicating evidence’ sub-project, the Academy recently held a roundtable for journalists and communications specialists, co-hosted by the Science Media Centre. The aim was to explore the roles and responsibilities of the media when reporting health-related information and to identify potential steps that can be taken to improve balance in reporting and accuracy of scientific evidence.

The discussions were wide ranging and helped both parties better understand the pressures they are subject to in their respective fields of work, and how these could lead to over-inflated claims. Specialist journalists highlighted that they put a lot of effort in ensuring good evidence gets into the media and often as much to prevent bad stories from being included in their publications. Access to additional experts, not just the authors of a study, helps them in this work.

Institutions such as the Academy and research-driven charities were mentioned as places to look for this independent expertise, and they should be prepared to increasingly play this role. The scientific community should not shy away from difficult or controversial topics, as this could only act to leave gaps that could then be filled by agendas rather than evidence.

All parties have a shared responsibility to help ensure the right evidence is communicated, not just as a way to promote their own work or to sell more copies, but for the benefit of patients and society at large.

Several steps were discussed to ensure more accurate reporting and to avoid overhyped stories to take hold of the headlines. These included improving press releases by including more caveats around limitations of studies, providing access to full research papers where possible, ensuring more access to experts for comment, and increasing scientific literacy in the newsroom.

Overall, the tone at the roundtable meeting was one of collaboration; all agreed that only by working together is accurate reporting ensured. There is also a need for wider conversations to take place, to engage other communities such as subeditors and other key editorial decision makers who have great influence over the published material.

1.Anthony Matthews, Emily Herrett, Antonio Gasparrini, Antonio, Tjeerd van Staa, Ben Goldacre, Liam Smeeth, Krishnan Bhaskaran, Impact of statin media coverage on the use of statins in the UK: an interrupted time series analysis using primary care data, BMJ. DOI: 10.1136/bmj.i3283 - See more on the LSHTM website.