Patient-Reported Reasons for Switching or Discontinuing Statin Therapy : A Mixed Methods Study Using Social Media

INTRODUCTION: Statin discontinuation can have major negative health consequences. Studying the reasons for discontinuation can be challenging as traditional data collection methods have limitations. We propose an alternative approach using social media. METHODS: We used natural language processing and machine learning to extract mentions of discontinuation of statin therapy from an online health forum, WebMD ( http://www.webmd.com ). We then extracted data according to themes and identified key attributes of the people posting for themselves. RESULTS: We identified 2121 statin reviews that contained information on discontinuing at least one named statin. Sixty percent of people posting declared themselves as female and the most common age category was 55-64 years. Over half the people taking statins did so for < 6 months. By far the most common reason given (90%) was patient experience of adverse events, the most common of which were musculoskeletal and connective tissue disorders. The rank order of adverse events reported in WebMD was largely consistent with those reported to regulatory agencies in the US and UK. Data were available on age, sex, duration of statin use, and, in some instances, adverse event resolution and rechallenge. In some instances, details were presented on resolution of the adverse event and rechallenge. CONCLUSION: Social media may provide data on the reasons for switching or discontinuation of a medication, as well as unique patient perspectives that may influence continuation of a medication. This information source may provide unique data for novel interventions to reduce medication discontinuation.