Abstract
BackgroundA large literature informs guidance for GPs about communicating quantitative risk information so as to facilitate shared decision making. However, relatively little has been written about how patients utilise such information in practice.AimTo understand the role of quantitative risk information in patients’ accounts of decisions about taking statins.Design and settingThis was a qualitative study, with participants recruited and interviewed in community settings.MethodSemi-structured interviews were conducted with 34 participants aged >50 years, all of whom had been offered statins. Data were analysed thematically, using elements of the constant comparative method.ResultsInterviewees drew frequently on numerical test results to explain their decisions about preventive medication. In contrast, they seldom mentioned quantitative risk information, and never offered it as a rationale for action. Test results were spoken of as objects of concern despite an often-explicit absence of understanding, so lack of understanding seems unlikely to explain the non-use of risk estimates. Preventive medication was seen as ‘necessary’ either to treat test results, or because of personalised, unequivocal advice from a doctor.ConclusionThis study’s findings call into question the assumption that people will heed and use numerical risk information once they understand it; these data highlight the need to consider the ways in which different kinds of knowledge are used in practice in everyday contexts. There was little evidence from this study that understanding probabilistic risk information was a necessary or valued condition for making decisions about statin use.
Highlights
Statin prescriptions for those at high cardiovascular risk have widely been seen as an important contributor to reducing the population burden of heart disease.[1]
This study’s findings call into question the assumption that people will heed and use numerical risk information once they understand it; these data highlight the need to consider the ways in which different kinds of knowledge are used in practice in everyday contexts
In the light of recent interest in risk communication, there is a need for more research on the specific question of what use is made of quantitative risk information in decision making about preventive medication
Summary
Statin prescriptions for those at high cardiovascular risk have widely been seen as an important contributor to reducing the population burden of heart disease.[1]. Patients’ general views of preventive medication use have been widely researched, with reported reservations about taking hypertensive medication[8] reflecting reservations found for long-term and preventive medications in general.[9] In the light of recent interest in risk communication, there is a need for more research on the specific question of what use is made of quantitative risk information in decision making about preventive medication. This article addresses this question through analysis of qualitative data generated in a study of how people make decisions about taking statins. Relatively little has been written about how patients utilise such information in practice
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