Communicating risk using absolute risk reduction or prolongation of life formats: cluster-randomised trial in general practice

Charlotte Gry Harmsen, Ivar Sønbø Kristiansen, Pia Veldt Larsen, Jørgen Nexøe, Henrik Støvring, Dorte Gyrd-Hansen, Jesper Bo Nielsen, Adrian Edwards, Dorte Ejg Jarbøl

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

BACKGROUND: It is important that patients are well-informed about risks and benefits of therapies to help them decide whether to accept medical therapy. Different numerical formats can be used in risk communication but It remains unclear how the different formats affect decisions made by real-life patients.

AIM: To compare the impact of using Prolongation Of Life (POL) and Absolute Risk Reduction (ARR) information formats to express effectiveness of cholesterol-lowering therapy on patients' redemptions of statin prescriptions, and on patients' confidence in their decision and satisfaction with the risk communication.

DESIGN AND SETTING: Cluster-randomised clinical trial in general practices. Thirty-four Danish GPs from 23 practices participated in a primary care-based clinical trial concerning use of quantitative effectiveness formats for risk communication in health prevention consultations.

METHOD: GPs were cluster-randomised (treating practices as clusters) to inform patients about cardiovascular mortality risk and the effectiveness of statin treatment using either POL or ARR formats. Patients' redemptions of statin prescriptions were obtained from a regional prescription database. The COMRADE questionnaire was used to measure patients' confidence in their decision and satisfaction with the risk communication.

RESULTS: Of the 240 patients included for analyses, 112 were allocated to POL information and 128 to ARR. Patients redeeming a statin prescription totalled six (5.4%) when informed using POL, and 32 (25.0%) when using ARR. The level of confidence in decision and satisfaction with risk communication did not differ between the risk formats.

CONCLUSION: Patients redeemed statin prescriptions less often when their GP communicated treatment effectiveness using POL compared with ARR.

Original languageEnglish
JournalBritish Journal of General Practice
Volume64
Issue number621
Pages (from-to)e199-e207
ISSN0960-1643
DOIs
Publication statusPublished - Apr 2014

Keywords

  • Cardiovascular disease
  • Decision making
  • General practice
  • Patient participation
  • Risk assessment
  • Risk communication

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