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Views on Treatment Necessity, Harm, and Benefits in Patients Using Statins
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. (Socialmedicinsk epidemiologi)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. (Socialmedicinsk epidemiologi)
2010 (English)In: Medical decision making, ISSN 0272-989X, E-ISSN 1552-681X, Vol. 30, no 5, 594-609 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND

Patients with dyslipidemia and high overall risk of ischemic heart disease are those most likely to benefit from treatment with statins. The objective of this study was to investigate patients' views of the necessity, harm, and expected benefits of their statin treatment, as well as factors associated with these treatment beliefs. One main objective was to investigate whether cardiovascular risk level and previous coronary heart disease affect the way patients view these different aspects of their medication.

METHODS

A total of 829 statin users were recruited while visiting a pharmacy to collect their statin medication (response rate, 69.4%). Patients returned a questionnaire assessing their medical history, concurrent risk status, social demographic factors, as well as their views and expectations regarding their statin treatment. RESULTS: Previous ischemic heart disease, or high risk of such disease, was not associated with a more favorable notion on statin treatment. Having an internal health locus of control as well as being satisfied with the physician's treatment explanation were factors associated with more positive views on expected treatment effect. The views on necessity, harm, and treatment benefit were closely associated with each other.

CONCLUSION

The main findings in this study suggest that cardiovascular risk level and previous coronary heart disease are not associated with the way patients value potential benefits of statin treatment. Patients' views of the treatment's necessity, harm, and benefits do not seem to be independent dimensions of patient beliefs but rather represent one overall question: is this good for me?

Place, publisher, year, edition, pages
2010. Vol. 30, no 5, 594-609 p.
Keyword [en]
Statins, prevention, patient expectations, patient views, cardiovascular risk
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Social Medicine
Identifiers
URN: urn:nbn:se:uu:diva-112924DOI: 10.1177/0272989X09353196ISI: 000283174800012PubMedID: 20008151OAI: oai:DiVA.org:uu-112924DiVA: diva2:288975
Available from: 2010-01-22 Created: 2010-01-22 Last updated: 2017-12-12Bibliographically approved
In thesis
1. Power of the Pill: Views about Cardiovascular Risk and the Risk-reducing Effect of Statins
Open this publication in new window or tab >>Power of the Pill: Views about Cardiovascular Risk and the Risk-reducing Effect of Statins
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Medical treatments with statins are prescribed to patients with increased risk of cardiovascular events. The benefits from statin treatment are well documented in clinical trials, but long-term adherence in patients is low, indicating that patients have an uncertainty about the necessity and benefits of treatment.

The aims of this thesis were to investigate how patients and doctors view different aspects of statin treatment. Further aims were to investigate if the cardiovascular risk level in patients affects their views about different aspects of statin treatment. Yet further aims were to compare health behaviours and views about risk factors in patients using statins to a non-treated population.

Data was obtained from patients (n = 829), doctors (n = 330) and a population sample (n = 720) using postal questionnaires. Views about the effect of statin treatment were assessed in different ways for patients and doctors. Patients based their assessments on their own situation, and doctors’ treatment decisions and assessments of anticipated effect of treatment were based on two hypothetical patient cases.

The results indicate that patients greatly overestimate the general effect of statins, compared to efficacy results reported from clinical trials. Patients’ previous coronary heart disease or high overall risk were factors not associated with their views and expectations of treatment effect. Statin users with an internally perceived health control and patients satisfied with their doctor’s treatment explanation reported higher beliefs in treatment necessity and benefits. Statin users reported having better health behaviours and generally rated risk factors as more important than the non-treated population. Doctors had suboptimal understanding of the number of patients expected to benefit following five years of statin treatment and had a varying understanding of statins’ ability to prolong life.

Overall the results illustrate that patients and doctors have different perspectives and views of the benefits from statin treatment which puts emphasis on how statin treatment is discussed in the clinical setting.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. 85 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 556
Keyword
Statins, lipid-lowering drugs, cholesterol, treatment expectations, beliefs, adherence, health behaviour
National Category
Public Health, Global Health, Social Medicine and Epidemiology Social and Clinical Pharmacy Family Medicine Public Health, Global Health, Social Medicine and Epidemiology Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Social Medicine
Identifiers
urn:nbn:se:uu:diva-121776 (URN)978-91-554-7793-6 (ISBN)
Public defence
2010-05-21, Enghoffsalen, Ingång 50, Akademiska sjukhuset, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2010-04-29 Created: 2010-03-30 Last updated: 2010-04-29Bibliographically approved

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Lytsy, PerBurell, GunillaWesterling, Ragnar

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