title: Providing additional information about the benefits of statins in a leaflet for patients with coronary heart disease: a qualitative study of the impact on attitudes and beliefs.
abstract: To explore the impact of providing additional information about the potential benefits of simvastatin in a patient leaflet on attitudes and beliefs.
  
  
  
  Interview-based study using a generic qualitative approach and framework analysis.
  
  
  
  21 participants receiving a prescription for simvastatin were recruited from a general practitioner practice (from a total of 120). 8 participants were women; the age range was 55-92.
  
  
  
  Participants were provided with leaflets showing one of 3 types of additional benefit information: (1) textual statement, (2) number needed to treat (NNT) or (3) natural frequency. Semistructured interviews explored patient's attitudes and beliefs.
  
  
  
  A descriptive narrative of preferences for format suggested patients prefer textual as opposed to numerical benefit information. Significant barriers to the acceptance of numerical benefit information included difficulty in understanding the numbers. Patients overestimated the benefits of statins and expressed surprise at the numerical information.
  
  
  
  Textual information was preferred but numerical information, in particular in the form of a natural frequency, may help patients make judgements about their medicines. NNTs were found to be very difficult to understand. This raises the prospect that some patients might reject medicines because of disappointment with the perceived low benefits of their medicines. The self-reported impact on behaviour appeared minimal with reports of intentions to 'do what the doctor tells me'. Further research is needed to explore the impact of such statements on people who are yet to be prescribed a statin.
authors.affiliation: School of Healthcare, University of Leeds, Leeds, UK.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Dickinson
authors.affiliation: School of Healthcare, University of Leeds, Leeds, UK.
authors.forename: David K
authors.initials: DK
authors.lastname: Raynor
authors.affiliation: Department of Health Sciences and The Hull York Medical School, University of York, York, UK.
authors.forename: Peter
authors.identifier: 0000-0001-5904-8699
authors.initials: P
authors.lastname: Knapp
authors.affiliation: Medicines and Healthcare Products Regulatory Agency, London, UK.
authors.forename: Jan
authors.initials: J
authors.lastname: MacDonald
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003327:Coronary Disease / Q000188:drug therapy; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010174:Pamphlets; D010353:Patient Education as Topic; D036301:Qualitative Research; D057566:Self Report; D019821:Simvastatin / Q000627:therapeutic use*; D006113:United Kingdom
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D019821:Simvastatin
keywords: medicines information; patient information; risk benefit communication; risk format