Skip to main content
Top
Published in: BMC Medical Informatics and Decision Making 1/2018

Open Access 01-12-2018 | Research article

Length of time periods in treatment effect descriptions and willingness to initiate preventive therapy: a randomised survey experiment

Authors: Erik Berglund, Ragnar Westerling, Johan Sundström, Per Lytsy

Published in: BMC Medical Informatics and Decision Making | Issue 1/2018

Login to get access

Abstract

Background

Common measures used to describe preventive treatment effects today are proportional, i.e. they compare the proportions of events in relative or absolute terms, however they are not easily interpreted from the patient’s perspective and different magnitudes do not seem to clearly discriminate between levels of effect presented to people.

Methods

In this randomised cross-sectional survey experiment, performed in a Swedish population-based sample (n = 1041, response rate 58.6%), the respondents, aged between 40 and 75 years were given information on a hypothetical preventive cardiovascular treatment. Respondents were randomised into groups in which the treatment was described as having the effect of delaying a heart attack for different periods of time (Delay of Event, DoE): 1 month, 6 months or 18 months. Respondents were thereafter asked about their willingness to initiate such therapy, as well as questions about how they valued the proposed therapy.

Results

Longer DoE:s were associated with comparatively greater willingness to initiate treatment. The proportions accepting treatment were 81, 71 and 46% when postponement was 18 months, 6 months and 1 month respectively. In adjusted binary logistic regression models the odds ratio for being willing to take therapy was 4.45 (95% CI 2.72–7.30) for a DoE of 6 months, and 6.08 (95% CI 3.61–10.23) for a DoE of 18 months compared with a DoE of 1 month. Greater belief in the necessity of medical treatment increased the odds of being willing to initiate therapy.

Conclusions

Lay people’s willingness to initiate preventive therapy was sensitive to the magnitude of the effect presented as DoE. The results indicate that DoE is a comprehensible effect measure, of potential value in shared clinical decision-making.
Literature
3.
go back to reference Wei L, Wang J, Thompson P, Wong S, Struthers AD, MacDonald TM. Adherence to statin treatment and readmission of patients after myocardial infarction: a six year follow up study. Heart. 2002;88(3):229–33.CrossRef Wei L, Wang J, Thompson P, Wong S, Struthers AD, MacDonald TM. Adherence to statin treatment and readmission of patients after myocardial infarction: a six year follow up study. Heart. 2002;88(3):229–33.CrossRef
5.
go back to reference WHO. Adherence to Long-term Therapies: Evidence for action. Geneva: World Health Organization; 2003. WHO. Adherence to Long-term Therapies: Evidence for action. Geneva: World Health Organization; 2003.
6.
go back to reference Hux JE, Naylor CD. Communicating the benefits of chronic preventive therapy: does the format of efficacy data determine patients' acceptance of treatment? Med Decis Mak. 1995;15(2):152–7.CrossRef Hux JE, Naylor CD. Communicating the benefits of chronic preventive therapy: does the format of efficacy data determine patients' acceptance of treatment? Med Decis Mak. 1995;15(2):152–7.CrossRef
7.
go back to reference Morris JN, Heady JA, Raffle PA, Roberts CG, Parks JW. Coronary heart-disease and physical activity of work. Lancet. 1953;265(6796):1111–20; concl.CrossRef Morris JN, Heady JA, Raffle PA, Roberts CG, Parks JW. Coronary heart-disease and physical activity of work. Lancet. 1953;265(6796):1111–20; concl.CrossRef
8.
go back to reference Edwards A, Elwyn G, Stott N. Communicating risk reductions. Researchers should present results with both relative and absolute risks. BMJ. 1999;318(7183):603 author reply −4.PubMed Edwards A, Elwyn G, Stott N. Communicating risk reductions. Researchers should present results with both relative and absolute risks. BMJ. 1999;318(7183):603 author reply −4.PubMed
9.
go back to reference Nexoe J, Gyrd-Hansen D, Kragstrup J, Kristiansen IS, Nielsen JB. Danish GPs' perception of disease risk and benefit of prevention. Fam Pract. 2002;19(1):3–6.CrossRef Nexoe J, Gyrd-Hansen D, Kragstrup J, Kristiansen IS, Nielsen JB. Danish GPs' perception of disease risk and benefit of prevention. Fam Pract. 2002;19(1):3–6.CrossRef
11.
go back to reference Misselbrook D, Armstrong D. Patients' responses to risk information about the benefits of treating hypertension. Br J Gen Pract. 2001;51(465):276–9.PubMedPubMedCentral Misselbrook D, Armstrong D. Patients' responses to risk information about the benefits of treating hypertension. Br J Gen Pract. 2001;51(465):276–9.PubMedPubMedCentral
16.
go back to reference Halvorsen PA, Selmer R, Kristiansen IS. Different ways to describe the benefits of risk-reducing treatments: a randomized trial. Ann Intern Med. 2007;146(12):848–56.CrossRef Halvorsen PA, Selmer R, Kristiansen IS. Different ways to describe the benefits of risk-reducing treatments: a randomized trial. Ann Intern Med. 2007;146(12):848–56.CrossRef
17.
go back to reference Christensen PM, Brosen K, Brixen K, Andersen M, Kristiansen IS. A randomized trial of laypersons' perception of the benefit of osteoporosis therapy: number needed to treat versus postponement of hip fracture. Clin Ther. 2003;25(10):2575–85.CrossRef Christensen PM, Brosen K, Brixen K, Andersen M, Kristiansen IS. A randomized trial of laypersons' perception of the benefit of osteoporosis therapy: number needed to treat versus postponement of hip fracture. Clin Ther. 2003;25(10):2575–85.CrossRef
23.
go back to reference Sniderman PM, Grob DB. Innovations in experimental Design in Attitude Surveys. Annu Rev Sociol. 1996;22:377–99.CrossRef Sniderman PM, Grob DB. Innovations in experimental Design in Attitude Surveys. Annu Rev Sociol. 1996;22:377–99.CrossRef
27.
go back to reference Horne R, Weinman J, Hankins M. The beliefs about medicines questionnaire: the development and evaluation of a new method for assessing the cognitive representation of medication. Psychol Health. 1999;14:1–24.CrossRef Horne R, Weinman J, Hankins M. The beliefs about medicines questionnaire: the development and evaluation of a new method for assessing the cognitive representation of medication. Psychol Health. 1999;14:1–24.CrossRef
41.
go back to reference Kristiansen IS, Gyrd-Hansen D, Nexoe J, Nielsen JB. Number needed to treat: easily understood and intuitively meaningful? Theoretical considerations and a randomized trial. J Clin Epidemiol. 2002;55(9):888–92.CrossRef Kristiansen IS, Gyrd-Hansen D, Nexoe J, Nielsen JB. Number needed to treat: easily understood and intuitively meaningful? Theoretical considerations and a randomized trial. J Clin Epidemiol. 2002;55(9):888–92.CrossRef
Metadata
Title
Length of time periods in treatment effect descriptions and willingness to initiate preventive therapy: a randomised survey experiment
Authors
Erik Berglund
Ragnar Westerling
Johan Sundström
Per Lytsy
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Medical Informatics and Decision Making / Issue 1/2018
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/s12911-018-0662-2

Other articles of this Issue 1/2018

BMC Medical Informatics and Decision Making 1/2018 Go to the issue