Patients’ Preferences for Ways to Communicate Benefits of Cardiovascular Medication

PURPOSE We wanted to determine patients’ willingness to take preventive cardiovascular disease (CVD) medication in relation to their 5-year CVD risk score and modes of communicating benefits of therapy. METHODS Study participants were 934 consecutive patients drawn from family practitioners’ waiting rooms in Auckland, New Zealand, who knew their 5-year CVD risk (ranging from 5% to 30%) and who completed a questionnaire asking them to rate how much various modes of communicating the benefits of therapy would encourage them to take medication daily, where the benefits from medication were proportional to their estimated CVD risk score. RESULTS Patients’ rankings for modes of communicating the benefits of therapy were little influenced by sex, age, ethnicity, numeracy score, 5-year CVD risk, or concern about a heart attack. Patients clearly found relative risk reduction most encouraging, with absolute risk reduction rated second overall and numbers needed to treat the least likely to be persuasive, although preferences covered the full range and were not predictable from demographic or 5-year CVD risk data. Pictures were preferred to numbers by 55.1%, with a people-chart or a bar chart being equally favored. Even so, 61.8% preferred a doctor’s opinion to any presentation by numbers or pictures. CONCLUSIONS Patients’ willingness to take preventive cardiovascular medication depends more on mode of communicating treatment benefit than on their short-term CVD risk score or their level of concern about a future cardiovascular event. Because individual preferences were not predictable, more than 1 modality is likely to be clinically useful for each patient.

[1]  F. Paccaud,et al.  Perception of cardiovascular risk and comparison with actual cardiovascular risk , 2009, European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology.

[2]  Stacey L. Sheridan,et al.  Individuals' responses to global CHD risk: a focus group study. , 2009, Patient education and counseling.

[3]  Rod Jackson,et al.  Patients Prefer Pictures to Numbers to Express Cardiovascular Benefit From Treatment , 2008, The Annals of Family Medicine.

[4]  Lisa M. Schwartz,et al.  PSYCHOLOGICAL SCIENCE IN THE PUBLIC INTEREST Helping Doctors and Patients Make Sense of Health Statistics , 2022 .

[5]  S. Buetow Non-Attendance for Health Care: When Rational Beliefs Collide , 2007 .

[6]  Ivar Kristiansen,et al.  Different Ways to Describe the Benefits of Risk-Reducing Treatments , 2007, Annals of Internal Medicine.

[7]  Andy Alaszewski,et al.  A Person-Centred Approach to Communicating Risk , 2005, PLoS medicine.

[8]  Ronald M Epstein,et al.  Communicating evidence for participatory decision making. , 2004, JAMA.

[9]  G. Elwyn,et al.  Effects of communicating individual risks in screening programmes: Cochrane systematic review , 2003, BMJ : British Medical Journal.

[10]  Andy Alaszewski,et al.  How can doctors communicate information about risk more effectively? , 2003, BMJ : British Medical Journal.

[11]  F. Houghton Degrees of Deprivation in New Zealand — An Atlas of Socioeconomic Difference: By P. Crampton, C. Salmond, R. Kirkpatrick, R. Scarborough and C. Skelly , 2001 .

[12]  C. Mulrow,et al.  Use of lipid lowering drugs for primary prevention of coronary heart disease: meta-analysis of randomised trials , 2000, BMJ : British Medical Journal.

[13]  R. Jackson Guidelines on preventing cardiovascular disease in clinical practice , 2000, BMJ : British Medical Journal.

[14]  Lisa M. Schwartz,et al.  The Role of Numeracy in Understanding the Benefit of Screening Mammography , 1997, Annals of Internal Medicine.

[15]  M. Mayo-Smith,et al.  Differences in Generalists' and Cardiologists' Perceptions of Cardiovascular Risk and the Outcomes of Preventive Therapy in Cardiovascular Disease , 1996, Annals of Internal Medicine.

[16]  C D Naylor,et al.  Communicating the Benefits of Chronic Preventive Therapy , 1995, Medical decision making : an international journal of the Society for Medical Decision Making.

[17]  B. Demichelis,et al.  Completeness of reporting trial results: effect on physicians' willingness to prescribe , 1994, The Lancet.

[18]  G. Elwyn,et al.  Presenting risk information--a review of the effects of "framing" and other manipulations on patient outcomes. , 2001, Journal of health communication.