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Table 3 Summary table

From: Views on primary prevention of cardiovascular disease - an interview study with Swedish GPs

RELIANCE

Fields of agreement

 
 

Too difficult and inappropriate to give the patient a numerical estimate of cardiovascular risk or risk score; more important to treat hypertension than hyperlipidaemia pharmaceutically; lifestyle intervention is more important for younger people; reduced drug prices influence prescribing criteria; individualization of advice and treatment is necessary; testing and prescribing drugs without proper indication can make patients feel ill

 

Fields of variation

 
 

1. Trust in pharmaceutical prevention

A. Firm trust in effectiveness and cost-effectiveness of pharmaceutical prevention

  

B. Some doubts about the effectiveness for the individual patient

  

C. Expressed doubts due to insufficient evidence

 

2. Trust in non-pharmaceutical prevention

A. Non-pharmaceutical treatment is the basis

  

B. Non-pharmaceutical treatment is too difficult to carry out and not very effective

  

C. Non-pharmaceutical treatment is not effective and it impairs the quality of life for the patients

 

3. Importance of a treatment goal

A. A pre-defined target is necessary

  

B. The importance of a target is varying: important for high-risk patients but not for low-risk patients

  

C. The lowering of blood-pressure or lipids is the most important, not to a certain value

 

4. Pharmaceutical prevention for different ages

A. More important for younger individuals

  

B. Equally important for young and old

  

C. More important for older individuals

RESPONSIBILITY

Fields of agreement

 
 

Genetic disposition is a significant risk factor; the "western" lifestyle causes cardiovascular disease; smoking is the most important lifestyle risk factor; a positive expectation that the intervention is beneficial is a necessary condition for compliance

 

Fields of variation

 
 

1. Information regarding potential adverse effects and length of treatment

A. Important to inform for the patient to be prepared and feel safe

  

B. Avoiding information is better, not to worry the patient

 

2. Treatment decision

A. The doctor has the main responsibility

  

B. A decision on equal terms is preferred

  

C. The patient has the main responsibility

 

3. The role of the doctor in non-pharmaceutical treatment

A. The doctor's role is to confront the patient with uncomfortable recommendations and make demands on the patient

  

B. The doctor's role is to communicate a positive message and encourage every little step the patient takes towards a healthier lifestyle

  

C. It is too difficult for the doctor to talk about lifestyle risk factors without blaming or burdening the patient. The doctor has no important role in non-pharmaceutical treatment

  

D. The doctor has no right to demand a change in the patient's lifestyle, but should instead prescribe pharmaceuticals for smokers and over-weight people