چکیده (انگلیسی):

Background:Guidelines for primary prevention of cardiovascular disease provide little guidance on how patients’
preferences should be taken into account. We wanted to explore whether general practitioners (GPs) are sensitive
to patient preferences regarding survival gains from statin therapy.
Methods:In a cross sectional, online survey 3,270 Norwegian GPs were presented with a 55 year old patient with
an unfavourable cardiovascular risk profile. He expressed preferences for statin therapy by indicating a minimum
survival gain that would be considered a substantial benefit. This survival gain varied across six versions of the
vignette: 8, 4 and 2 years, and 12, 6 and 3 months, respectively. Participants were randomly allocated to one
version only. We asked whether the GPs would recommend the patient to take a statin. Subsequently we asked
the GPs to estimate the average survival gain of life long simvastatin therapy for patients with a similar risk profile.
Results:We received 1,296 responses (40 %). Across levels of survival gains (8 years to 3 months) the proportion of
GPs recommending statin therapy did not vary significantly (OR per level 1.07, 95 % CI 0.99 to 1.16). The GP’s own
estimate of survival gain was a statistically significant predictor of recommending therapy (OR per year adjusted for
the GPs’ age, sex, speciality attainment and number of patients listed 3.07, CI 2.55 to 3.69).
Conclusion:GPs were insensitive to patient preferences regarding survival gain when recommending statin
therapy. The GPs' recommendations were strongly associated with their own estimates of survival gain.