Article Figures & Data
Figures
- Figure 1
Ranks assigned to modes of risk communication (from1=most to 5=least).
Tables
Variable n % Sex Male 477 51.1 Female 457 48.9 Ethnicity European/other 693 74.2 Māori 72 7.7 Pacific Islander 55 5.9 Asian 114 12.2 Age range, y 31–40 44 4.7 41–50 199 21.3 51–60 273 29.2 61–70 237 25.4 >70 181 19.4 Highest education Primary 42 4.5 Secondary 464 49.7 Technical 188 20.1 University 240 25.7 Numeracy score 0 85 9.1 1 201 21.5 2 306 32.8 3 342 36.6 Social deprivation of domicile 1 (least deprived) 249 26.7 2 214 22.9 3 166 17.8 4 110 11.8 5 (most deprived) 166 17.8 Missing 29 3.1 - Table 2
Participant’s Rankings for Numerical Explanatory Modes That Would Encourage Them to Take Medication and Help Them to Make a Decision (N = 934)
Would Encourage to Take Medication Would Help to Make a Decision Mode Ranked 1st n (%) Reversed Rank Suma Ranked 1st n (%) Reversed Rank Suma Relative risk reduction 605 (64.8) 4,042 603 (64.5) 3,988 Absolute risk 107 (11.5) 3,040 131 (14.0) 3,149 Natural frequencies 103 (11.0) 2,080 91 (9.7) 1,989 Odds 85 (9.1) 2,706 76 (8.1) 2,668 Number needed to treat 32 (3.4) 2,136 32 (3.4) 2,213 -
↵a Reversed rank sum is the sum of rank scores after they have been reversed so that rank 1 is given a value of 5, rank 2 is given a value of 4, and so on.
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Item Mean (SD)a Concern about a heart attack 4.1 (2.5) Perceived likelihood of a heart attack 3.7 (2.4) Keenness to take medication 7.0 (3.3) n (%) Prefer pictures to numbers 516 (55.2) Prefer people chart to bar graph 468 (50.1) Prefer positively framed to negatively framed statement 650 (69.6) No preference 211 (22.6) Prefer doctor to give opinion rather than explain using numbers and/or pictures 577 (61.8) No preference 12 (1.3) -
↵a Scored on a 10-point scale in which 1 = least concern/perceived likelihood/ keenness, and 10 = most concerned/perceived likelihood/keenness.
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- Table 4
Linear Regressions of Associations With Keenness to Take Medication and With Perceived Likelihood of Having Heart Attack
Association Coefficient P Value Associations with keenness to take medicationa Calculated cardiovascular disease risk 0.38 .01 Perceived likelihood of heart attack 0.35 <.001 Primary school education only 1.38 .02 Older age 0.31 .02 Associations with perceived likelihood of having a heart attackb Calculated cardiovascular disease risk 0.40 <.001 Numeracy −0.28 .002 Education level −0.25 <.001 Māori 1.13 0.002 Concern about heart attack 0.22 0.001 - Table 5
Comparing Groups by First-Ranked Responses For Mode of Risk Communication That Would Most Encourage Them to Take Medication
Explanatory Mode Compared With RRR Coefficient P Value Absolute risk reduction Numeracy −0.11 .14 Follows horse racing 0.02 .96 Prefer pictures to numbers −0.14 .27 Concern about heart attack −0.04 .34 Pacific Islander 0.10 .58 Asian 0.66 .003 Natural frequencies Numeracy −0.34 .002 Follows horse racing 0.89 <.001 Prefer pictures to numbers 0.60 .02 Concern about heart attack −0.07 .23 Pacific Islander 1.55 <.001 Asian 1.44 <.001 Odds Numeracy −0.07 .40 Follows horse racing 0.53 <.001 Prefer pictures to numbers −0.39 .09 Concern about heart attack −0.15 <.001 Pacific Islander 0.33 .38 Asian −0.04 .77 Number needed to treat Numeracy −0.05 .64 Follows horse racing 0.91 <.001 Prefer pictures to numbers −0.27 .12 Concern about heart attack −0.14 .05 Pacific Islander 0.47 .38 Asian 0.75 .18 -
RRR=relative risk reduction.
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Note: Multinomial logistic regression with first preference for relative risk taken as the reference group (n = 880, pseudo R2=0.05).
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Supplemental Appendix
Supplemental Appendix. The Questionnaire, Using the Example Given to Patients at Approximately 15% 5-year Risk of a Cardiovascular Event
Files in this Data Supplement:
- Supplemental data: Appendix - PDF file, 6 pages, 459 KB
The Article in Brief
Patients' Preferences for Ways to Communicate Benefits of Cardiovascular Medication
Felicity Goodyear-Smith , and colleagues
Background This study examined patient preferences for ways in which doctors communicate the benefits of taking medication to prevent cardiovascular disease.
What This Study Found Patients prefer a doctor give his or her opinion about the medication rather than explain the risks using numbers or pictures. Moreover, patients prefer visual depictions to words. Specifically, the study of 934 patients in Auckland, New Zealand, found 62 percent preferred to know what their doctor thinks about the medication, and 55 percent preferred pictorial presentations to numbers. Patients showed a strong preference for relative risk as a means of encouraging them to take preventive medication.
Implications
- Patients� willingness to take preventive cardiovascular medication depends more on the way in which treatment benefit is communicated than on their cardiovascular disease risk score or level of concern about a future cardiovascular episode.
- It is not possible to predict which mode of communication individual patients will prefer. As a result, the authors recommend clinicians use several methods and formats to communicate risk, matching information to the needs of individuals.
