期刊
ANNALS OF FAMILY MEDICINE
卷 9, 期 2, 页码 121-127出版社
ANNALS FAMILY MEDICINE
DOI: 10.1370/afm.1193
关键词
Risk assessment; risk management; decision making; family practice; cardiovascular diseases
资金
- National Heart Foundation of New Zealand
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.
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