School of Population Health, The University of Auckland, Auckland, New Zealand.
General Practice Clinical Unit, The University of Queensland, Level 8, Health Sciences Building, Brisbane, Qld, Australia.
Fam Pract. 2022 Sep 24;39(5):897-902. doi: 10.1093/fampra/cmab186.
There is increasing evidence for the potential benefits and harms of cardiovascular disease (CVD) medications in older people (>75 years) prompting updating of clinical guidelines. We explored the views of older people about CVD medication to inform guideline development.
Qualitative study using semistructured interviews and focus groups. An ethnically diverse group of community dwelling older people were purposefully recruited from northern New Zealand using flyers in primary care clinics, local libraries, social groups, and places of worship, and by word of mouth. Interviews and focus groups were digitally recorded, transcribed verbatim, and analysed using an iterative and inductive approach to thematic analysis.
Thirty-nine participants from 4 ethnic groups were recruited (mean 74 years; range 61-91 years; Māori (7), South Asian (8), European (9), and Pasifika (15)). Most participants were taking CVD medication/s. Four main themes emerged: (i) emphasizing the benefits of CVD medication and downplaying the harms; (ii) feeling compelled to take medication; (iii) trusting "my" doctor; and (iv) expecting medication to be continued.
Findings raise questions about older people's agency in decision-making regarding CVD medication. CVD risk management guidelines for older people could include strategies to support effective communication of the potential benefits and harms of CVD medication in older people, balancing life expectancy, and the expected duration of therapy.
越来越多的证据表明心血管疾病 (CVD) 药物对老年人（>75 岁）具有潜在的益处和危害，这促使临床指南进行更新。我们探讨了老年人对 CVD 药物的看法，以为指南制定提供信息。
使用半结构式访谈和焦点小组进行定性研究。通过在初级保健诊所、当地图书馆、社会团体和礼拜场所的传单，以及通过口口相传，从新西兰北部的社区中有意招募了具有不同种族背景的 39 名社区居住的老年人参与研究。访谈和焦点小组被数字记录、逐字转录，并使用迭代和归纳的主题分析方法进行分析。
从 4 个种族群体中招募了 39 名参与者（平均年龄 74 岁；年龄范围 61-91 岁；毛利人（7）、南亚人（8）、欧洲人（9）和太平洋岛民（15））。大多数参与者正在服用 CVD 药物。出现了四个主要主题：（i）强调 CVD 药物的益处，淡化其危害；（ii）感到被迫服用药物；（iii）信任“我的”医生；以及（iv）期望继续服用药物。
研究结果引发了关于老年人在 CVD 药物决策方面的自主权问题。针对老年人的 CVD 风险管理指南可以包括支持有效沟通 CVD 药物对老年人的潜在益处和危害的策略，平衡预期寿命和治疗的预期持续时间。
