Patient preferences for cardiovascular preventive medication

A systematic review

Research output: Contribution to journalArticleResearchpeer-review

10 Citations (Scopus)
87 Downloads (Pure)

Abstract

OBJECTIVE: To systematically review current evidence regarding the minimum acceptable risk reduction of a cardiovascular event that patients feel would justify daily intake of a preventive medication.

METHODS: We used the Web of Science to track the forward and backward citations of a set of five key articles until 15 November 2016. Studies were eligible if they quantitatively assessed the minimum acceptable benefit-in absolute values-of a cardiovascular disease preventive medication among a sample of the general population and required participants to choose if they would consider taking the medication.

RESULTS: Of 341 studies screened, we included 22, involving a total of 17 751 participants: 6 studied prolongation of life (POL), 12 studied absolute risk reduction (ARR) and 14 studied number needed to treat (NNT) as measures of risk reduction communicated to the patients. In studies framed using POL, 39%-54% (average: 48%) of participants would consider taking a medication if it prolonged life by <8 months and 56%-73% (average: 64%) if it prolonged life by ≥8 months. In studies framed using ARR, 42%-72% (average: 54%) of participants would consider taking a medication that reduces their 5-year cardiovascular disease (CVD) risk by <3% and 50%-89% (average: 77%) would consider taking a medication that reduces their 5-year CVD risk by ≥3%. In studies framed using 5-year NNT, 31%-81% (average: 60%) of participants would consider taking a medication with an NNT of >30 and 46%-87% (average: 71%) with an NNT of ≤30.

CONCLUSIONS: Many patients require a substantial risk reduction before they consider taking a daily medication worthwhile, even when the medication is described as being side effect free and costless.

Original languageEnglish
Pages (from-to)1578-1586
Number of pages9
JournalHeart
Volume103
Issue number20
Early online date13 May 2017
DOIs
Publication statusPublished - 1 Oct 2017

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Numbers Needed To Treat
Patient Preference
Risk Reduction Behavior
Life Support Care
Cardiovascular Diseases
Population

Cite this

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title = "Patient preferences for cardiovascular preventive medication: A systematic review",
abstract = "OBJECTIVE: To systematically review current evidence regarding the minimum acceptable risk reduction of a cardiovascular event that patients feel would justify daily intake of a preventive medication.METHODS: We used the Web of Science to track the forward and backward citations of a set of five key articles until 15 November 2016. Studies were eligible if they quantitatively assessed the minimum acceptable benefit-in absolute values-of a cardiovascular disease preventive medication among a sample of the general population and required participants to choose if they would consider taking the medication.RESULTS: Of 341 studies screened, we included 22, involving a total of 17 751 participants: 6 studied prolongation of life (POL), 12 studied absolute risk reduction (ARR) and 14 studied number needed to treat (NNT) as measures of risk reduction communicated to the patients. In studies framed using POL, 39{\%}-54{\%} (average: 48{\%}) of participants would consider taking a medication if it prolonged life by <8 months and 56{\%}-73{\%} (average: 64{\%}) if it prolonged life by ≥8 months. In studies framed using ARR, 42{\%}-72{\%} (average: 54{\%}) of participants would consider taking a medication that reduces their 5-year cardiovascular disease (CVD) risk by <3{\%} and 50{\%}-89{\%} (average: 77{\%}) would consider taking a medication that reduces their 5-year CVD risk by ≥3{\%}. In studies framed using 5-year NNT, 31{\%}-81{\%} (average: 60{\%}) of participants would consider taking a medication with an NNT of >30 and 46{\%}-87{\%} (average: 71{\%}) with an NNT of ≤30.CONCLUSIONS: Many patients require a substantial risk reduction before they consider taking a daily medication worthwhile, even when the medication is described as being side effect free and costless.",
author = "Loai Albarqouni and Jenny Doust and Paul Glasziou",
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Patient preferences for cardiovascular preventive medication : A systematic review. / Albarqouni, Loai; Doust, Jenny; Glasziou, Paul.

In: Heart, Vol. 103, No. 20, 01.10.2017, p. 1578-1586.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Patient preferences for cardiovascular preventive medication

T2 - A systematic review

AU - Albarqouni, Loai

AU - Doust, Jenny

AU - Glasziou, Paul

N1 - © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

PY - 2017/10/1

Y1 - 2017/10/1

N2 - OBJECTIVE: To systematically review current evidence regarding the minimum acceptable risk reduction of a cardiovascular event that patients feel would justify daily intake of a preventive medication.METHODS: We used the Web of Science to track the forward and backward citations of a set of five key articles until 15 November 2016. Studies were eligible if they quantitatively assessed the minimum acceptable benefit-in absolute values-of a cardiovascular disease preventive medication among a sample of the general population and required participants to choose if they would consider taking the medication.RESULTS: Of 341 studies screened, we included 22, involving a total of 17 751 participants: 6 studied prolongation of life (POL), 12 studied absolute risk reduction (ARR) and 14 studied number needed to treat (NNT) as measures of risk reduction communicated to the patients. In studies framed using POL, 39%-54% (average: 48%) of participants would consider taking a medication if it prolonged life by <8 months and 56%-73% (average: 64%) if it prolonged life by ≥8 months. In studies framed using ARR, 42%-72% (average: 54%) of participants would consider taking a medication that reduces their 5-year cardiovascular disease (CVD) risk by <3% and 50%-89% (average: 77%) would consider taking a medication that reduces their 5-year CVD risk by ≥3%. In studies framed using 5-year NNT, 31%-81% (average: 60%) of participants would consider taking a medication with an NNT of >30 and 46%-87% (average: 71%) with an NNT of ≤30.CONCLUSIONS: Many patients require a substantial risk reduction before they consider taking a daily medication worthwhile, even when the medication is described as being side effect free and costless.

AB - OBJECTIVE: To systematically review current evidence regarding the minimum acceptable risk reduction of a cardiovascular event that patients feel would justify daily intake of a preventive medication.METHODS: We used the Web of Science to track the forward and backward citations of a set of five key articles until 15 November 2016. Studies were eligible if they quantitatively assessed the minimum acceptable benefit-in absolute values-of a cardiovascular disease preventive medication among a sample of the general population and required participants to choose if they would consider taking the medication.RESULTS: Of 341 studies screened, we included 22, involving a total of 17 751 participants: 6 studied prolongation of life (POL), 12 studied absolute risk reduction (ARR) and 14 studied number needed to treat (NNT) as measures of risk reduction communicated to the patients. In studies framed using POL, 39%-54% (average: 48%) of participants would consider taking a medication if it prolonged life by <8 months and 56%-73% (average: 64%) if it prolonged life by ≥8 months. In studies framed using ARR, 42%-72% (average: 54%) of participants would consider taking a medication that reduces their 5-year cardiovascular disease (CVD) risk by <3% and 50%-89% (average: 77%) would consider taking a medication that reduces their 5-year CVD risk by ≥3%. In studies framed using 5-year NNT, 31%-81% (average: 60%) of participants would consider taking a medication with an NNT of >30 and 46%-87% (average: 71%) with an NNT of ≤30.CONCLUSIONS: Many patients require a substantial risk reduction before they consider taking a daily medication worthwhile, even when the medication is described as being side effect free and costless.

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U2 - 10.1136/heartjnl-2017-311244

DO - 10.1136/heartjnl-2017-311244

M3 - Article

VL - 103

SP - 1578

EP - 1586

JO - British Heart Journal

JF - British Heart Journal

SN - 1355-6037

IS - 20

ER -