既往研究已证实他汀可减少冠脉支架置入患者的心血管事件发生率，当前指南也推荐这类人群常规使用他汀类药物。但约半数患者在第一年内停药，并在随访期间依从性下降。药物依从性受很多因素影响，包括患者对疾病的感知和理解，其他因素还有社会经济地位低、药物话费高和不了解药物说明书等。

        此外，媒体报道也可能对患者药物依从性和健康相关行为有影响。为验证这一结论，土耳其学者开展了一项回顾性分析。研究纳入908例经皮冠状动脉介入治疗(PCI)患者，分析他汀治疗的依从性。使用基于药物覆盖天数比例(PDC)方法量化他汀治疗依从性，在 Google上以“胆固醇药物”为关键词检索相应的新闻页面。

        结果显示，检索到2011年、2012年、2013年和2014年的新闻分别为2320条、6210条、5170条和3070条。随着2011到2013年关于他汀新闻条数的明显增加，他汀治疗天数百分比呈现显著减少的趋势，从2011年的57%到2012年的58%再到2013年的50%(P=0.01)，见下图。

        该研究表明，从2011年至2013年他汀治疗依从性明显下降，患者接触到的关于他汀负面新闻可解释这一结果。研究者在文中写道，这是首个揭示媒体负面报道对药物依从性影响的研究。

        相关论文近期发表于《国际心脏病学杂志》(International Journal of Cardiology)。

        参考文献：CuneytKocas, et al. International Journal of Cardiology .December 15, 2015Volume 201, Page 139. DOI:http://dx.doi.org/10.1016/j.ijcard.2015.07.095

原文

The role of media on statin adherence
Cuneyt Kocas ⁎, Okay Abaci, Betul Balaban Kocas, Gokhan Cetinkal, Sukru Arslan, Ahmet Yildiz, Murat Ersanli
Istanbul University Institute of Cardiology, Department of Cardiology, Turkey

Statins have been reported to reduce the incidence of cardiovascular events after coronary stenting and current guidelines recommend the routine use of statins in this population. But, about half of patients discontinue statin therapy within the first year, and adherence decreases during follow-up period [1,2].Medication adherence is a complex problem that is affected by many factors, including perceptions and understanding of the disease burden. Specific factors identified include low socioeconomic status, high medication costs, lack of transportation and poor understanding of medication instructions [3]. In addition,media coverage of health facts may also have an impact on beliefs,and behaviors related to health. Niederdeppe et al. [4] reported that exposure to statin advertisements increased the diagnosis of hypercholesterolemia
and use of statins. However in recent years, statins were frequently criticized in Turkish media and most of them were also presented in a negative fashion in globalmedia. Our goalwas to analyze the effects of media on statin adherence.
We retrospectively analyzed the statin adherence of 908 percutaneous coronary intervention patients whom were prescribed a statin before 2011 at our institute and had continuous insurance coverage to determine statin adherence. We used the pharmacy-based proportion of days covered (PDC) method to quantify statin adherence. To quantify the effects of media, we made a search on Google. We searched theword “cholesterol drugs” on Turkish pages from “news” section for 2011 to 2014 individually.Search on Google retrieved; 2320 news in 2011, 6210 news in 2012,5170 news in 2013 and 3070 news in 2014. As news about statins increased dramatically from 2011 to 2013, percentage of days covered by statins significantly decreased (57% (IQR: 8–83) in 2011, 58% (IQR :17–83) in 2012 and 50% (IQR: 8–83) in 2013, p = 0.01). (Fig. 1)

Our study demonstrated that statin adherence decreased from2011 to 2013 significantly and this finding can be explained by the exposure of patients to negative news about statins in media. To our knowledge this is the first study which demonstrates the negative role of media on medication adherence.