Getting the word out
By Ruth SoRelle, M.P.H.
Sometimes I'm just wrong.
I have a Facebook account and I have a Twitter account, although I must admit that I give both short shrift. Facebook is a good way for me to see photos of my new nephew who lives far away, and I read Lance Armstrong's reactions to the Tour de France on Twitter. I never thought that either could play a significant role in health communication. They haven't yet, but that's sure to change. After a recent study that showed the change in the use of drug-coated stents in the journal Circulation: Cardiovascular Quality and Outcomes, I am expecting that their day is coming.
Drug-eluting stents
The stent story is one of rapid communication using traditional media – newspapers, television and radio – and the newer vehicles that rely on the internet.
It began with some startling studies I was at the meeting of the European Society of Cardiology during the summer of drug-eluting stents in the early part of this century. Stents are those little cages or springs interventional cardiologists thread into clogged coronary arteries to hold them open. The stents were bare metal and as many as one-quarter of them became blocked again within a year. Researchers came up with the idea of coating them with a drug that seemed to prevent them from clogging up again. When the first studies came out, these drug-eluting stents became very popular. In fact, by 2006, approximately 90 percent of patients who had suffered a particular kind of heart attack and received a stent were given one coated in drugs to prevent the artery from renarrowing.
However, 2006 was the year when a series of new studies showed that the drug-coated stents were more likely to be associated with blood clots that occurred in the artery one or more years after the stent was put in place. The news was spread widely in the medical community – by a variety of means, including print, television and in web-based publications.
A consortium of researchers looked at how this wide-spread coverage affected the use of the stents. Their report was published at the end of July 2009. The researchers tracked the change in practice among physicians from the release of those dramatic studies in 2006.
Dramatic drop in drug-eluting stents
By the end of March 2007, doctors were using the stents with drugs in only 67 percent of stent placements. By the beginning of 2008, they accounted for 58 percent of stent placements.
The researchers called this a "rapid change in practice patterns." Perhaps, they said, it was the most rapid change ever seen in the specialty of cardiology.
Electronic spread of information
In a released statement, Clyde W. Yancy, M.D., president of the American Heart Association, said, "This study demonstrates the dynamic shifts that are occurring in the distribution of medical information. The opportunity to widely share important findings that promptly impact practice is becoming a powerful tool to drive change. The requirements for prompt but thorough peer review and nimble responsiveness to new data are evident. Managing this new health IT space will require focus, assessment and realignment."
In an era of health reform when policymakers are concentrating on finding out which treatments work best for which people as a way of improving care and saving money, it is important to view this new information about the spread of medical information in a careful light. Now, more than ever, it is important that the source and validity of information receive careful attention from anyone who seeks to apply it.
More and more information in different formats
As we become more accustomed to getting our information electronically, we will learn the valid sources of information. And who knows – it may end up being some form of Facebook or Twitter.
