School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
BMC Fam Pract. 2011 Jun 26;12:59. doi: 10.1186/1471-2296-12-59.
There are now effective drugs to prevent cardiovascular disease and guidelines recommend their use. Patients do not always choose to accept preventive medication at levels of risk reduction recommended in guidelines. The purpose of the study was to identify and explore the attitudes of patients and general practitioners towards preventative medication for cardiovascular disease (CVD) after they have received information about it; to identify implications for practice and prescribing.
Qualitative interviews with GPs and patients following presentation of in depth information about CVD risks and the absolute effects of medication.
GP practices in Birmingham, United Kingdom.
In both populations: wide variation on attitudes to preventative medication; concerns about unnecessary drug taking & side effects; preferring to consider lifestyle changes first. In patient population: whatever their attitudes to medication were, the vast majority explained that they would ultimately do what their GP recommended; there was some misunderstanding of the distinction between curative and preventative medication. A common theme was the degree of trust in their doctors' judgement and recommendations, which contrasted with scepticism of the role of pharmaceutical companies and academics. Scepticism in guidelines was also common among doctors although many nevertheless recommended treatment for their patients
A guideline approach to prescribing preventative medication could be against the interests and preferences of the patient. GPs must take extra care to explain what preventative medication is and why it is recommended, attempt to discern preferences and make recommendations balancing these potentially conflicting concerns.
目前已有预防心血管疾病的有效药物，且指南推荐使用这些药物。但患者接受的风险降低水平的预防药物并不总是按照指南建议选择。本研究的目的是确定并探讨患者和全科医生在接受心血管疾病（CVD）预防药物相关信息后，对其的态度；明确实践和处方的意义。
对英国伯明翰的全科医生和患者进行深入的 CVD 风险和药物绝对效果信息介绍后的定性访谈。
在全科医生的诊室。
在这两个群体中：对预防药物的态度存在广泛差异；担心不必要的药物服用和副作用；更愿意首先考虑生活方式的改变。在患者群体中：无论他们对药物的态度如何，绝大多数人都表示最终会听从他们的医生的建议；他们对治疗药物和预防药物之间的区别存在一些误解。一个常见的主题是对医生判断和建议的信任程度，这与对制药公司和学术界角色的怀疑形成鲜明对比。医生对指南也持怀疑态度，但尽管如此，许多医生仍为患者推荐治疗。
开预防药物的处方时，采用指南方法可能不符合患者的利益和偏好。全科医生必须格外注意解释预防药物是什么，以及为什么建议使用它，试图辨别偏好，并在这些潜在冲突的问题上提出建议。
