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. 2024 Mar 8:40:102681.
doi: 10.1016/j.pmedr.2024.102681. eCollection 2024 Apr.

Patients' preferences for secondary prevention following a coronary event

Tinka J van Trier  1 , Harald T Jørstad  1 , Wilma J M Scholte Op Reimer  1   2 , Madoka Sunamura  3   4 , Nienke Ter Hoeve  3   5 , G Aernout Somsen  6 , Ron J G Peters  1 , Marjolein Snaterse  1
Affiliations

Patients' preferences for secondary prevention following a coronary event

Tinka J van Trier et al. Prev Med Rep. .

Abstract

Objective: Despite clear evidence on the effectiveness of secondary prevention, patients with coronary artery disease frequently fail to reach guideline-based risk factor targets. Integrating patients' preferences into treatment decisions has been recommended to reduce this gap. However, this requires knowledge about patient treatment preferences. Therefore, through a survey study, we aimed to explore which risk factors patients self-perceived, prioritised for improvement, and needed support with after a recent hospitalisation for coronary heart disease.

Methods: A digital questionnaire was presented to patients > 18 years recently discharged (≤3 months) from an acute coronary care unit in the Netherlands (Europe). Patients could select from eight cardiovascular risk factors that they (1) self-perceived, (2) prioritised for improvement, and (3) needed support to improve. Patients' perceived risk factors were compared to those documented in the medical records.

Results: Respondents (N = 254, 26 % women), mean age 64 (SD 10) years, identified 'physical inactivity' more frequently than their medical records (140 patients vs. 91 records, p < 0.001), while three other risk factors were reported with equal and four with lower frequency. 'Physical inactivity', 'overweight' and 'stress' were most frequently prioritised for improvement (82 %, 88 % and 78 %) and professional support (64 %, 50 % and 58 %), with 87 % preferring lifestyle optimisation if this would reduce drug use.

Conclusions: Patients with a recent coronary event show significant disparities in identifying risk factors compared to their medical records. They tend to prefer improving lifestyle- over drug-modifiable risk factors, particularly physical inactivity, overweight and stress, and indicate the need for support in improving these factors.

Keywords: Cardiovascular disease; Lifestyle; Patient preferences; Rehabilitation; Risk factors.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Marjolein Snaterse reports financial support was provided by Dutch Research Council (SIA/NWO), grant number 23 HBOPD.2018.02.035. Harald Jorstad reports financial support was provided by an unrestricted grant from AMGEN. The other authors (Tinka J. van Trier, Wilma JM. Scholte op Reimer, Madoka Sunamura, Nienke ter Hoeve, G. Aernout Somsen and Ron J.G. Peters) of the manuscript ‘Patients' Preferences for Secondary Prevention Following a Coronary Event’ have nothing to declare; none of them have competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Cardiovascular risk factors reported by 254 Dutch adult patients within three months after coronary event. Upper panel: applicable according to patients (red dots) compared to their medical records (triangles). Lower panel: percentage of patients that reported the risk factor as important to improve (red dots) and for which professional help is desired (blue dots). The number of patients who perceived a risk factor is reported after the y-axis label and determines the denominator. Top answers given (stress, overweight and physical inactivity) are highlighted by a semi-transparent rectangle.
See this image and copyright information in PMC

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