EconPapers    
Economics at your fingertips  
 

Primary Prevention Drug Therapy: Can It Meet Patients’ Requirements for Reduced Risk?

Hilary A. Llewellyn-Thomas, J. Michael Paterson, Judy A. Carter, Antoni Basinski, Martin G. Myers, Gordon D. Hardacre, Earl V. Dunn, Ralph B. D’Agostino, Philip A. Wolf and C. David Naylor
Additional contact information
Hilary A. Llewellyn-Thomas: Center for the Evaluative Clinical Sciences, Department of Community and Family Medicine, Dartmouth Medical School, Hanover, New Hampshire, Clinical Epidemiology Unit, Institute for Clinical Evaluative Sciences, Sunnybrook & Women’s College Health Science Centre, Toronto, Ontario, Canada
J. Michael Paterson: Institute for Clinical Evaluative Sciences, Sunnybrook & Women’s College Health Science Centre, Toronto, Ontario, Canada
Judy A. Carter: Institute for Clinical Evaluative Sciences, Sunnybrook & Women’s College Health Science Centre, Toronto, Ontario, Canada
Antoni Basinski: Clinical Epidemiology Unit, Institute for Clinical Evaluative Sciences, Sunnybrook & Women’s College Health Science Centre, Toronto, Ontario, Canada, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
Martin G. Myers: Department of Medicine, University of Toronto, Toronto, Ontario, Canada
Gordon D. Hardacre: Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
Earl V. Dunn: Clinical Epidemiology Unit, Sunnybrook & Women’s College Health Science Centre, Toronto, Ontario, Canada, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
Ralph B. D’Agostino: Department of Mathematics, Boston University, Boston, Massachusetts
Philip A. Wolf: Departments of Neurology and Medicine, Boston University, Boston, Massachusetts
C. David Naylor: Clinical Epidemiology Unit, Institute for Clinical Evaluative Sciences, Sunnybrook & Women’s College Health Science Centre, Toronto, Ontario, Canada, Department of Medicine, University of Toronto, Toronto, Ontario, Canada

Medical Decision Making, 2002, vol. 22, issue 4, 326-339

Abstract: The objective was to identify, in primary prevention, patients whose “required risk reduction†(ReqRR) is greater than the “achievable risk reduction†(ARR) that cholesterol-lowering or antihypertensive medication could provide. Individualized estimates of 10-year coronary heart disease or stroke risk were derived for 66 hypercholesterolemic (HC) and 64 hypertensive (HT) patients without symptomatic cardiovascular disease. These estimates were used in trade-off tasks identifying each individual’s ReqRR. Then individual ARRs were estimated (in HC patients by assuming total cholesterol/high density lipoprotein ratio reductions to 5.0; in HT patients by assuming systolic blood pressure reductions to 120 mmHg). 12 (18%) HC and 12 (19%) HT subjects would refuse medication regardless of the risk reduction offered. Of the remaining patients, 15/54 (28%; 95% C.I.: 16-40%) HC and 19/52 (37%; 95% C.I.: 24-51%) HT subjects were “over-requirers,†in that their ReqRR/ARR ratio was 1.5. There may be a notable proportion of patients whose ReqRR is considerably greater than what is achievable, implying that decision aids may help individuals clarify preferences about accepting/refusing medication for the primary prevention of cardiovascular disease.

Keywords: treatment preferences; hypertension; hypercholesterolemia; primary prevention; patients’ decision aids; trade-off technique (search for similar items in EconPapers)
Date: 2002
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://journals.sagepub.com/doi/10.1177/0272989X0202200411 (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:22:y:2002:i:4:p:326-339

DOI: 10.1177/0272989X0202200411

Access Statistics for this article

More articles in Medical Decision Making
Bibliographic data for series maintained by SAGE Publications ().

 
Page updated 2025-03-19
Handle: RePEc:sae:medema:v:22:y:2002:i:4:p:326-339