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Patient expectations on lipid-lowering drugs
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, Social Medicine. (Socialmedicinsk epidemiologi)
2007 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 67, no 1-2, 143-150 p.Article in journal (Refereed) Published
Abstract [en]

Objective

The objective of this study was to assess expectations of effect when using statins in a treatment population. Further the aim was to examine factors, including history and concurrent risk of coronary heart disease, associated with a higher and lower treatment belief.

Methods

Eight hundred and twenty-nine (829) Swedish patients using statins completed postal questionnaires about their health, life style, cardiovascular risk factors and expectation of the treatment. Expected treatment benefit was used as outcome measurement.

Results

A medical history of coronary heart disease did not affect treatment expectations. Patients with a high risk of cardiovascular disease reported a slightly lower expectation of the treatment effect at a 10-year perspective (p<0.01) but not at shorter time perspectives. Low satisfaction with the explanation of the purpose of the treatment and a poor perceived control of own health was associated with a more negative view on treatment benefit.

Conclusion

The rationale applied by physicians prescribing statins does not seem to relate to the patients’ expectations, whereas factors relating to the patient–physician relationship, the social situation and the perceived control of health seem to affect patient belief.

Practice implications

The association between patients’ poor satisfaction of treatment explanation and a low belief in treatment benefits emphasizes the importance of the patient–physician communication. It is suggested that clinical tools are developed in order to identify patients with poor belief in treatment benefit since tailored education for this group might reduce the risk of non-compliance and subsequently reduce the risk of coronary heart disease.

Place, publisher, year, edition, pages
2007. Vol. 67, no 1-2, 143-150 p.
Keyword [en]
(MeSH), Cholesterol, Patient expectations, Prevention, Hydroxymethylglutaryl-CoA reductase inhibitors
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-11270DOI: 10.1016/j.pec.2007.03.004ISI: 000248014200020PubMedID: 17433602OAI: oai:DiVA.org:uu-11270DiVA: diva2:39038
Available from: 2007-08-21 Created: 2007-08-21 Last updated: 2017-12-11Bibliographically 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, PerWesterling, Ragnar

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