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Decisions on statin therapy by patients’ opinions about survival gains: cross sectional survey of general practitioners

BACKGROUND: Guidelines for primary prevention of cardiovascular disease provide little guidance on how patients’ preferences should be taken into account. We wanted to explore whether general practitioners (GPs) are sensitive to patient preferences regarding survival gains from statin therapy. METHO...

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Autores principales: Halvorsen, Peder A., Aasland, Olaf Gjerløw, Kristiansen, Ivar Sønbø
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4490724/
https://www.ncbi.nlm.nih.gov/pubmed/26139240
http://dx.doi.org/10.1186/s12875-015-0288-8
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author Halvorsen, Peder A.
Aasland, Olaf Gjerløw
Kristiansen, Ivar Sønbø
author_facet Halvorsen, Peder A.
Aasland, Olaf Gjerløw
Kristiansen, Ivar Sønbø
author_sort Halvorsen, Peder A.
collection PubMed
description BACKGROUND: Guidelines for primary prevention of cardiovascular disease provide little guidance on how patients’ preferences should be taken into account. We wanted to explore whether general practitioners (GPs) are sensitive to patient preferences regarding survival gains from statin therapy. METHODS: In a cross sectional, online survey 3,270 Norwegian GPs were presented with a 55 year old patient with an unfavourable cardiovascular risk profile. He expressed preferences for statin therapy by indicating a minimum survival gain that would be considered a substantial benefit. This survival gain varied across six versions of the vignette: 8, 4 and 2 years, and 12, 6 and 3 months, respectively. Participants were randomly allocated to one version only. We asked whether the GPs would recommend the patient to take a statin. Subsequently we asked the GPs to estimate the average survival gain of life long simvastatin therapy for patients with a similar risk profile. RESULTS: We received 1,296 responses (40 %). Across levels of survival gains (8 years to 3 months) the proportion of GPs recommending statin therapy did not vary significantly (OR per level 1.07, 95 % CI 0.99 to 1.16). The GP’s own estimate of survival gain was a statistically significant predictor of recommending therapy (OR per year adjusted for the GPs’ age, sex, speciality attainment and number of patients listed 3.07, CI 2.55 to 3.69). CONCLUSION: GPs were insensitive to patient preferences regarding survival gain when recommending statin therapy. The GPs' recommendations were strongly associated with their own estimates of survival gain.
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spelling pubmed-44907242015-07-04 Decisions on statin therapy by patients’ opinions about survival gains: cross sectional survey of general practitioners Halvorsen, Peder A. Aasland, Olaf Gjerløw Kristiansen, Ivar Sønbø BMC Fam Pract Research Article BACKGROUND: Guidelines for primary prevention of cardiovascular disease provide little guidance on how patients’ preferences should be taken into account. We wanted to explore whether general practitioners (GPs) are sensitive to patient preferences regarding survival gains from statin therapy. METHODS: In a cross sectional, online survey 3,270 Norwegian GPs were presented with a 55 year old patient with an unfavourable cardiovascular risk profile. He expressed preferences for statin therapy by indicating a minimum survival gain that would be considered a substantial benefit. This survival gain varied across six versions of the vignette: 8, 4 and 2 years, and 12, 6 and 3 months, respectively. Participants were randomly allocated to one version only. We asked whether the GPs would recommend the patient to take a statin. Subsequently we asked the GPs to estimate the average survival gain of life long simvastatin therapy for patients with a similar risk profile. RESULTS: We received 1,296 responses (40 %). Across levels of survival gains (8 years to 3 months) the proportion of GPs recommending statin therapy did not vary significantly (OR per level 1.07, 95 % CI 0.99 to 1.16). The GP’s own estimate of survival gain was a statistically significant predictor of recommending therapy (OR per year adjusted for the GPs’ age, sex, speciality attainment and number of patients listed 3.07, CI 2.55 to 3.69). CONCLUSION: GPs were insensitive to patient preferences regarding survival gain when recommending statin therapy. The GPs' recommendations were strongly associated with their own estimates of survival gain. BioMed Central 2015-07-03 /pmc/articles/PMC4490724/ /pubmed/26139240 http://dx.doi.org/10.1186/s12875-015-0288-8 Text en © Halvorsen et al. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Halvorsen, Peder A.
Aasland, Olaf Gjerløw
Kristiansen, Ivar Sønbø
Decisions on statin therapy by patients’ opinions about survival gains: cross sectional survey of general practitioners
title Decisions on statin therapy by patients’ opinions about survival gains: cross sectional survey of general practitioners
title_full Decisions on statin therapy by patients’ opinions about survival gains: cross sectional survey of general practitioners
title_fullStr Decisions on statin therapy by patients’ opinions about survival gains: cross sectional survey of general practitioners
title_full_unstemmed Decisions on statin therapy by patients’ opinions about survival gains: cross sectional survey of general practitioners
title_short Decisions on statin therapy by patients’ opinions about survival gains: cross sectional survey of general practitioners
title_sort decisions on statin therapy by patients’ opinions about survival gains: cross sectional survey of general practitioners
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4490724/
https://www.ncbi.nlm.nih.gov/pubmed/26139240
http://dx.doi.org/10.1186/s12875-015-0288-8
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