This story accurately reported on the results of a recent study and at the same time engendered enthusiasm not supported by the current data for the use of a single pill that contained a group of 5 different medications for heart disease. While the study enrolled individuals who could be calculated to be at increased risk of heart attack or stroke, the story went on to speculate about the use of this ‘polypill’ for use as a preventative medication. The story should have included some discussion about the difference between treatment and prevention of conditions.
The story included discussion of psychologic benefits which could be gained through the use of a combined pill as opposed to individual medications without providing any background on where the data demonstrating this came from.
While there is reason to think that there may be benefits to be gained through the use of multi-action medications, there ought to be some critical thought given to the impact of medication of this nature when used in older individuals or in those being treated for other conditions with drugs that might interact with a combination medication of this nature.
The line that states "Taking it could cut a person’s risk of heart disease and stroke roughly in half, the study concludes” overwhelms several other good features of the story. That statement makes it seem like it was tested for its effect on cardiovascular outcomes, when it has only been shown to reduce risk factor levels in a short-term study.
To its credit, the story included comments with caveats that were not included in some other news accounts.
As this is not an available treatment, the cost was presented as something not yet known. The story suggested that the cost for the pill would likely be something less than $17/month – the cost for its component medications.
The story did not provide a rational for why the expected costs would be less than the costs for the individual medications on their own. Nonetheless, it tried to address cost.
The benefits of treatment in terms of blood pressure, LDL cholesterol, triglycerides, HDL, and anti-clotting were presented However, it is premature to present an estimate for the reduction in heart attack and stroke as the time frame of the study presented is much too short to inform us as to whether this is the case.
There was no discussion of harms of treatment beyond a statement that the side effect rates for the polypill were the same as for the medications individually. While this was what was observed in the current 12 week trial, the reader should have been reminded of the short term nature of the study, the limited demographics of the study population, and that conclusions, although informed by the common long-term use of the component medications, still require analysis of the effects these medications may have in individuals who may not have all of the underlying conditions being treated.
Although the story did an adequate job of describing the results of the study, it did not confine itself to discussion of the observed outcomes but chose to focus on extrapolating the results to what might be the longer term benefit. Stating that this pill could ‘cut a person’s risk of heart disease and stroke roughly in half, the study concludes’ implies that the pill was tested for its effect on cardiovascular outcomes, when in fact it has only been shown to reduce risk factors levels in a single, short-term study. This is misleading.
The story did not engage in overt disease mongering.
Quotes from a number of clinicians involved in the current study, and individuals who were supportive or critical of the current treatment approach were included in this story.
While the story failed to mention options other than the use of multiple pharmaceuticals to lower risk of heart attack and stroke, it did touch on the use of the drugs separately rather than in combined form.
The story made clear that the combination pill discussed was experimental, while at the same time indicating that all of its components were available as generic medications.
The novelty of such a polypill was appropriately portrayed.
Does not appear to rely on a press release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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