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Good adherence to taking placebo associated with 47% lower mortality vs poor adherence (15% vs 28%)
Saturday, March 23, 2019 2:12 pm Email this article
Good adherence to taking a cholesterol-lowering drug known as clofibrate was associated with a 39% lower mortality compared to those with poor adherence to taking clofibrate (15% mortality vs 24.6% mortality) according to a 1980 study, however the same thing was true for placebo; those with good adherence to taking placebo was associated with a 47% lower mortality compared to those with poor adherence to taking placebo (15.1% mortality vs 28.3% mortality).
The authors of this 1980 study concluded, “These findings and various other analyses of mortality in the clofibrate and placebo groups of the project show the serious difficulty, if not impossibility, of evaluating treatment efficacy in subgroups determined by patient responses (e.g., adherence or cholesterol change) to the treatment protocol after randomization.”
Beware of any study which claims that adherence to statins or any other drug will lower your risk of death, because the same thing is true if you take a placebo.
In other words, it is NOT a drug effect, but rather it is that people who adhere to any advice are different than those who don’t adhere and this what accounts for the lower risk of mortality.
Dr. Kendrick wrote more about this here.
Influence of adherence to treatment and response of cholesterol on mortality in the coronary drug project. N Engl J Med, 1980 Oct 30; 303(18): 1038-1041.
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