TY  - JOUR
T1  - EFfects of benefits and harms on older persons' willingness to take medication for primary cardiovascular prevention
AU  - Fried TR, Tinetti ME, Towle V, O’Leary JR, Iannone L
Y1  - 2011/05/23
N1  - 10.1001/archinternmed.2011.32
JO  - Archives of Internal Medicine
SP  - 923
EP  - 928
VL  - 171
IS  - 10
N2  - 
Guidelines for primary disease prevention are based on the goal of reduced risk of disease-specific outcomes, such as myocardial infarction (MI) or stroke. Implicit in these guidelines is the judgment that these benefits outweigh any potential harms of intervention, a view shared by many clinicians.3- 4 However, there is evidence that these judgments may not agree with the way in which patients view benefits and harms. Qualitative studies demonstrate that, for many persons considering primary prevention interventions, there is a “cost” associated with the very act of taking a medication.5 In addition, adverse medication effects are viewed by patients as unacceptable outcomes in their own right.6- 8 Several small quantitative studies have shown considerable variability in the amount of benefit that a primary prevention therapy would need to provide in order for a patient to be willing to take the medication.9- 10 These studies leave unanswered the question of the relative importance of benefits and harms of medications and how patients weigh these against one another. Disagreements between how guidelines and patients value the benefits and harms of medications may be particularly relevant for older adults who have multiple risk factors for chronic disease and meet criteria for many guideline-directed medications for primary prevention. The purpose of the current study was to examine how the willingness of older adults to take medication for primary cardiovascular disease prevention is affected by the likelihood of reduction in MI and the type and severity of adverse medication effects. It also sought to determine how well they understood the probabilistic information about the benefits of therapy.

SN  - 0003-9926
M3  - doi: 10.1001/archinternmed.2011.32
UR  - http://dx.doi.org/10.1001/archinternmed.2011.32
ER  -