The effectiveness of personalized coronary heart disease and stroke risk communication.

Abstract

Background

Current guidelines recommend global risk assessment to guide vascular risk factor management; however, most provider-patient communication focuses on individual risk factors in isolation. We sought to evaluate the impact of personalized coronary heart disease and stroke risk communication on patients' knowledge, beliefs, and health behavior.

Methods

We conducted a randomized controlled trial testing personalized risk communication based on Framingham stroke and coronary heart disease risk scores compared with a standard risk factor education. A total of 89 patients were recruited from primary care clinics and followed up for 3 months. Outcomes included the following: risk perception and worry, risk factor knowledge, risk reduction preferences and decision conflict, medication adherence, health behaviors, and blood pressure.

Results

Participants had a very low understanding of numeric information, high perceived risk for stroke or myocardial infarction, and high proportion of medication nonadherence. Patients' ability to identify vascular risk factors increased with personalized risk communication (mean 1.8 additional risk factors, 95% CI 1.3-2.2) and standard risk factor education (mean 1.6 additional risk factors, 95% CI 1.1-2.1) immediately after the intervention but was not sustained at 3 months. Patients in the personalized group had less decision conflict than the standard risk factor education group over intended risk reduction strategies (5.9 vs 10.1, P = .003). There was no appreciable impact of either communication strategy on medication adherence, exercise, smoking cessation, or blood pressure.

Conclusions

Personalized risk communication was preferred by patients and had a small impact on risk reduction preferences and decision conflict but had no impact on patient beliefs or behavior compared with standard risk factor education.

Type

Journal article

Department

Description

Provenance

Subjects

Humans, Coronary Disease, Risk Assessment, Risk Factors, Health Knowledge, Attitudes, Practice, Communication, Risk Reduction Behavior, Decision Making, Aged, Middle Aged, Female, Male, Stroke

Citation

Published Version (Please cite this version)

10.1016/j.ahj.2010.12.021

Publication Info

Powers, Benjamin J, Susanne Danus, Janet M Grubber, Maren K Olsen, Eugene Z Oddone and Hayden B Bosworth (2011). The effectiveness of personalized coronary heart disease and stroke risk communication. American heart journal, 161(4). pp. 673–680. 10.1016/j.ahj.2010.12.021 Retrieved from https://hdl.handle.net/10161/30098.

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