Abstract

Objectives: Online health information (OHI) about statin use has created debates among healthcare professionals and the public. As a result, online misinformation about statins has led to an increase in the discontinuation of statins. OHI has been shown to influence patients’ health decisions and behaviours. This study explores the views and experiences of OHI-seeking about statins in patients with high cardiovascular risk and how OHI influences patient decision-making and statin adherence. Designs and method: This is a qualitative study with semi-structured in-depth interviews of 20 patients with high cardiovascular risk from a primary care clinic in Malaysia. We included participants who were at least 18 years old and had high cardiovascular risk where statin use is indicated as per guideline (i.e. with pre-existing cardiovascular disease (CVD), diabetes mellitus, chronic kidney disease, a 10-year risk for CVD > 20% based on the Framingham General CVD risk score) and have sought OHI about statins. We used an interpretive description approach with thematic analysis. Results: The age of the participants ranged from 39–74 years, with 16 (80%) participants having hypertension. 12 (60%) participants took a statin for primary CVD prevention. The duration of statin use ranged from 2 weeks to 30 years. Six themes emerged from the interviews (Figure 1): (1) Participants sought different types of OHI throughout the disease trajectory depending on their information needs, (2) There is a changing paradigm of OHI-seeking behaviour, where passive exposure to OHI appears to have increased relative to active searching, (3) Participants sought a wide range of OHI from hypercholesterolemia, lifestyle modification and complementary alternative medicine, (4) Statin-related OHI was mainly negative and stressed the side effects of statins, (5) OHI triggered emotional reactions that may affect patients’ decision on statin adherence, (6) Doctors’ responses to participants’ OHI-seeking behaviour affected patient-doctor communication and patients’ decision in taking statins. Conclusions: This study highlights the changing information needs throughout patient journeys, suggesting the opportunity to provide needs-oriented OHI to patients with high cardiovascular risk. Passive OHI exposure appears to have an influence on patients’ adherence to statins. The quality of patient-doctor communication about OHI-seeking behaviour remains a critical factor in patient decision making. Doctors should discuss patients’ information needs and OHI-seeking behaviour throughout the disease trajectory and provide evidence-based health information to patients. Strategies are needed to address patients’ concerns about statins, acknowledge their emotional reactions toward OHI and support their need for evidence-based OHI.

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