Journal article
Influence of Cardiovascular Risk Communication Tools and Presentation Formats on Patient Perceptions and Preferences
JAMA cardiology, Vol.3(12), pp.1192-1199
12/01/2018
DOI: 10.1001/jamacardio.2018.3680
PMCID: PMC6551302
PMID: 30419113
Abstract
Practice guidelines recommend that clinicians engage patients in treatment decisions and explain atherosclerotic cardiovascular disease (ASCVD) risk but do not describe how to communicate this risk most effectively.
To determine how the ASCVD risk time horizon, outcome, and presentation format influence risk perceptions and treatment preferences.
From May 27, 2015, through November 12, 2015, participants from the Patient and Provider Assessment of Lipid Management Registry at 140 US cardiology, primary care, and endocrinology practices were presented 3 independent scenarios (representing the same hypothetical patient) and asked to rate their perceived risk and willingness to take medication to lower risk in light of (1) a 15% 10-year ASCVD event risk, (2) a 4% 10-year cardiovascular disease (CVD) death risk, and (3) a 50% lifetime ASCVD event risk.
Participants were randomized to receive risk estimates using numbers only, a bar graph, or a face pictogram.
Of 3566 eligible participants, 2708 (76.9%) responded (median age, 67 years [interquartile range, 61-76 years]; 280 [10.3%] African American; 1491 men [55.1%]). When shown the lifetime ASCVD risk, respondents were more likely to consider the risk "high to very high" than when presented the 10-year ASCVD risk or the CVD death risk (70.1% vs 31.4% vs 25.7%, respectively; both P < .001). Treatment willingness was also the highest for lifetime ASCVD risk (77.9% very willing) followed by 10-year ASCVD risk (68.1%) and 10-year CVD death risk (63.1%; both P < .001). Compared with participants who were shown a bar graph or no graphic, those who were shown the risk information with a pictogram had the lowest perception of disease severity and the lowest willingness to consider therapy. These findings were robust across demographic and socioeconomic subgroups.
The format, time horizon, and outcome used for risk estimation influence patient perceptions and should be considered when designing risk communication tools. When shown lifetime risk estimates, patients had higher risk perception and willingness for therapy than when shown 10-year estimates. Pictogram risk displays may decrease risk perception and consideration for treatment.
Details
- Title: Subtitle
- Influence of Cardiovascular Risk Communication Tools and Presentation Formats on Patient Perceptions and Preferences
- Creators
- Ann Marie Navar - Duke Clinical Research Institute, Duke University School of Medicine, Durham, North CarolinaTracy Y Wang - Duke Clinical Research Institute, Duke University School of Medicine, Durham, North CarolinaXiaojuan Mi - Duke Clinical Research Institute, Duke University School of Medicine, Durham, North CarolinaJennifer G Robinson - University of Iowa, Iowa CitySalim S Virani - Baylor College of Medicine, Houston, TexasVeronique L Roger - Mayo Clinic, Rochester, MinnesotaPeter W F Wilson - Emory University, Atlanta, GeorgiaAnne C Goldberg - Washington University in St Louis, St Louis, MissouriEric D Peterson - Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
- Resource Type
- Journal article
- Publication Details
- JAMA cardiology, Vol.3(12), pp.1192-1199
- Publisher
- United States
- DOI
- 10.1001/jamacardio.2018.3680
- PMID
- 30419113
- PMCID
- PMC6551302
- ISSN
- 2380-6583
- eISSN
- 2380-6591
- Grant note
- K01 HL133416 / NHLBI NIH HHS
- Language
- English
- Date published
- 12/01/2018
- Academic Unit
- Epidemiology; Internal Medicine
- Record Identifier
- 9983995045102771
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