title: Patient and general practitioner attitudes to taking medication to prevent cardiovascular disease after receiving detailed information on risks and benefits of treatment: a qualitative study.
abstract: BACKGROUND
  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.
  
  
  METHODS
  Qualitative interviews with GPs and patients following presentation of in depth information about CVD risks and the absolute effects of medication.
  
  
  METHODS
  GP practices in Birmingham, United Kingdom.
  
  
  RESULTS
  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
  
  
  CONCLUSIONS
  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.
authors.affiliation: School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. n.gale@bham.ac.uk
authors.forename: Nicola K
authors.initials: NK
authors.lastname: Gale
authors.forename: Sheila
authors.initials: S
authors.lastname: Greenfield
authors.forename: Paramjit
authors.initials: P
authors.lastname: Gill
authors.forename: Kerry
authors.initials: K
authors.lastname: Gutridge
authors.forename: Tom
authors.initials: T
authors.lastname: Marshall
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D018890:Chemoprevention; D005260:Female; D058006:General Practice; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D036301:Qualitative Research; D012307:Risk Factors