Factors involved in deciding to start preventive treatment: qualitative study of clinicians' and lay people's attitudes

摘要: Objectives To explore the views of clinicians and lay people about minimum benefit needed to justify drug treatment prevent heart attacks, rationale behind decisions. Design Qualitative study using semi-structured interviews. Participants 4 general practitioners, practice nurses, 18 people. Setting 8 practices 6 community settings across Liverpool. Results Participants varied widely in acceptable benefits chosen. Most found concepts difficult initially, few appreciated that increased length should increase absolute benefits. Lay usually wanted make decisions for themselves, supported this. consider adverse effects costs treatment. Dislike taking was common, many preferred lifestyle change an imperfect Quality life personal were more important than individual's age. Conclusions Evidence based guidelines assumptions people's preferences, and, by 10 year estimates risk, inflate apparent It is unlikely could incorporate wide range true dialogue necessary between patients before starting long term preventive