Predictors of Informed People's Preferences for Statin Therapy to Reduce Cardiovascular Disease Risk: an Internet Survey Study.

BACKGROUND

Guidelines suggest clinicians inform patients about their 10-year cardiovascular disease (CVD) risk; however, little is known about how the risk estimate influences patients' preferences for statin therapy for primary prevention.

OBJECTIVE

To define predictors of preference for statin therapy after participants were informed about their individualized benefits and harms.

DESIGN

Cross-sectional survey in 2020.

SETTING

Online US survey panel.

PARTICIPANTS

A national sample of 304 respondents aged 40 to 75 who had not previously taken a statin and who knew their cholesterol levels and blood pressure measurements.

INTERVENTION

Participants entered their risk factors into a calculator which estimated their 10-year CVD risk. They were then provided with an estimate of their absolute risk reduction with a statin and the chance of side effects from meta-analyses.

MAIN MEASUREMENTS

We used a hierarchical model to predict participants' preferences for statin therapy according to their 10-year CVD risk, perceptions of the magnitude of statin benefit (large, medium, small, or almost no benefit), worry about side effects (very worried, somewhat worried, a little worried, not worried at all), and other variables.

KEY RESULTS

Participants had a mean age of 55 years (SD = 9.9); 50% were female, 44% were non-white, and 16% had a high school degree or less education. After reviewing their benefits and side effects, 45% of the participants reported they probably or definitely wanted to take a statin. In the full hierarchical model, only perceived benefits of taking a statin was a significant independent predictor of wanting a statin (OR 7.3, 95% CI 4.7, 12.2).

LIMITATIONS

Participants were from an internet survey panel and making hypothetical decisions.

CONCLUSIONS

Participants' perceptions of their benefit from statin therapy predicted wanting to take a statin for primary prevention; neither estimated CVD risk nor worries about statin side effects were independent predictors.