Patients' Expectations of Screening and Preventive Treatments

The Article in Brief

Ben Hudson , and colleagues

Background An informed decision about whether to accept screening and preventive care requires balancing the potential benefits and harms of the intervention. This study assesses participants' estimates of the benefit, as well as the minimum acceptable benefit, of screening for breast and bowel cancer and of medication to prevent hip fracture and cardiovascular disease.

What This Study Found Many patients appear willing to undergo preventive care on the basis of overly optimistic expectations of the benefits of preventive interventions and screening. Data from 354 patient questionnaires found that participants overestimated the degree of benefit of all interventions. A lower level of education was associated with higher estimates of minimum acceptable benefit for all interventions. Increasing age was associated with higher levels of minimum acceptable benefit for all interventions other than hip fracture prevention.

Implications

• The authors conclude that, when counseling patients, physicians should consider these misperceptions, which may impair informed decision making about the use of such interventions.
• Clinicians should also consider using decision aids when discussing preventive care, especially with older patients and those with a lower level of education, as the aids may reduce patients' tendency to overestimate intervention benefits.