Patient attitudes to commonly promoted medical interventions

• Published in: Medical journal of Australia 2000-01, Vol.172 (1), p.9-12
• Main Authors: Fitzgerald, Stephen P, Phillipov, George
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Attitude to Health; Biological and medical sciences; Cardiology. Vascular system; Coronary Artery Bypass; Coronary heart disease; Evidence-Based Medicine; Female; General aspects; Heart; Hormone Replacement Therapy; Humans; Male; Medical sciences; Middle Aged; Patient Satisfaction; Planification. Prevention (methods). Intervention. Evaluation; Primary Prevention; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Assessment; South Australia; Surveys and Questionnaires; Thrombolytic Therapy; Tropical medicine
• ISSN: 0025-729X; 1326-5377
• DOI: 10.5694/j.1326-5377.2000.tb123869.x

Objective: To survey attitudes about three “best practice” medical interventions (hormone replacement therapy [HRT], thrombolysis for acute myocardial infarction [THROM] and coronary artery by‐pass surgery [CABS]) in a sample of patients, and identify factors associated with those attitudes. Settings: Metropolitan tertiary care hospital outpatient clinics (survey 1, April 1997), two general practice surgeries (survey 2, May 1997), and one general practice surgery (survey 3, October 1997). Design: Patients completed a questionnaire while waiting for their clinical consultation. Attitude scores were measured on an 11‐category Likert scale ranging from ‐5 (definitely would not) to +5 (definitely would) for acceptance of proposed medication or surgery. Participants: 85 (participation rate, 85%), 77 (94%) and 95 (97%) in surveys 1, 2 and 3, respectively. Surveys 1 and 2 constituted the primary study group (n = 162). Patients aged ≥50 years or reporting heart disease were excluded from the HRT analyses; patients aged ≥65 years were excluded from the THROM and CABS analyses. Results: The median attitude scores for HRT (n = 58), THROM and CABS (n = 111) were ‐2.95 (95% Cl, ‐5 to ‐2.1), ‐0.5 (95% Cl, ‐0.9 to 0) and ‐0.1 (95% Cl, ‐0.5 to + 1.3), respectively. Decreasing the risk‐benefit ratio fourfold for HRT in survey 3 (n = 68) increased the median score to ‐0.75 (95% Cl, ‐2.3 to 0). Conclusions: Patients do not view favourably the risk‐benefit ratio of the three surveyed medical interventions. These attitudes may present a major impediment to most primary prevention programs.