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Predictors of patients’ preferences for treatments to prevent heart disease
  1. T Marshall1,
  2. S Bryan2,
  3. P Gill3,
  4. S Greenfield3,
  5. K Gutridge1,
  6. Birmingham Patient Preferences Group
  1. 1Department of Public Health & Epidemiology, University of Birmingham, Birmingham, UK
  2. 2Health Services Management Centre, University of Birmingham, Birmingham, UK
  3. 3Department of Primary Care and General Practice, University of Birmingham, Birmingham, UK
  1. Correspondence to:
    Dr Tom Marshall
    Department of Public Health & Epidemiology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; T.P.Marshall{at}bham.ac.uk

Abstract

Objectives: To determine the relationship between expressed preferences for drug treatment to prevent coronary disease and several participant and general practitioner characteristics among patients attending coronary risk screening.

Design: Face-to-face interviews with patients. At the first interview, a researcher asked participants to imagine six scenarios representing different levels of pretreatment five-year coronary risk. In each case they were asked whether they would choose treatment that would reduce their coronary risk by 30% of pretreatment risk. At the second interview participants were told their coronary risk and asked whether they would choose treatment. Sociodemographic variables were collected to investigate their relationship to patients’ treatment preferences.

Participants: Patients identified as likely to be at high coronary risk were invited to attend for risk screening and to participate in the study.

Setting: 13 practices in the West Midlands.

Results: Participants’ preferences varied widely: at the first interview 112 (55.2%) of 203 participants preferred treatment at 3% five-year coronary risk but 31 (15.3%) preferred no treatment even at 30% five-year coronary risk. Age, sex, education and drug treatment history did not affect preferences, but lower social class was associated with preferring treatment at lower risk. Preferences expressed at the second interview were generally consistent with preferences at the first interview (κ  =  0.510, 95% CI 0.380 to 0.639).

Conclusions: Patients attending for coronary risk screening express stable preferences for drug treatment to prevent coronary heart disease. Their preferences vary widely and may be associated with social class.

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Footnotes

  • Published Online First 18 May 2006

  • TM conceived the idea that was developed by SB, PG, SG and KG. KG collected the data. TM wrote the first draft and all authors contributed to the final version.

  • Financial support for this study was provided by a grant from the UK Medical Research Council and with support from the Primary Care Clinical Research and Trials Unit, University of Birmingham. The funding agreement ensured the authors’ independence in designing the study, interpreting the data, and writing and publishing the report.

  • Competing interests: None declared.

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