Highlights
- •English-speaking countries have the largest number of websites about statin side effects.
- •The number of websites about statin side effects in a country was correlated with its prevalence of statin intolerance.
- •The nocebo effect driven by internet searches may be contributing to statin intolerance.
Abstract
Background
The nocebo effect, where patients with expectations of adverse effects are more likely
to experience them, may contribute to the high rate of statin intolerance found in
observational studies. Information that patients read on the internet may be a precipitant
of this effect. The objective of the study was to establish whether the number of
websites about statin side effects found using Google is associated with the prevalence
of statin intolerance.
Methods
The prevalence of statin intolerance in 13 countries across 5 continents was established
in a recent study via a web-based survey of primary care physicians and specialists.
Using the Google search engine for each country, the number of websites about statin
side effects was determined, and standardized to the number of websites about statins
overall. Searches were restricted to pages in the native language, and were conducted
after connecting to each country using a virtual private network (VPN).
Results
English-speaking countries (Australia, Canada, UK, USA) had the highest prevalence
of statin intolerance and also had the largest standardized number of websites about
statin side effects. The sample Pearson correlation coefficient between these two
variables was 0.868.
Conclusions
Countries where patients using Google are more likely to find websites about statin
side effects have greater levels of statin intolerance. The nocebo effect driven by
online information may be contributing to statin intolerance.
Keywords
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Article info
Publication history
Accepted:
February 20,
2018
Received in revised form:
February 16,
2018
Received:
October 23,
2017
Footnotes
☆Each author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
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- Statins – Good drugs, not so good reputationInternational Journal of CardiologyVol. 262
