Involve patients in CV disease prevention decisions, say experts
Aggressive cardiovascular disease prevention strategies are “medicalising” patients
but without involving them in understanding the risks, experts suggested
at an event organised by the Royal College
of Physicians of Edinburgh this week. “Cardiovascular medicine — turning people into
patients: has modern medicine gone too far?” brought together cardiovascular
specialists to debate this issue and the potential impact for the NHS.
Simon Maxwell, senior lecturer at the clinical pharmacology unit, University
of Edinburgh, told The Journal that current treatment guidelines gather
a considerable number of people into the category where they could receive
drugs. He said that, although there is evidence suggesting that medicines
can reduce the level of cardiovascular risk, there is little dialogue
taking place with patients about their own preferences.
Gordon McInnes, vice-president of the British Hypertension Society and
professor of clinical pharmacology, University of Glasgow, presented
a review of evidence on interventions to reduce cardiovascular risk of
individuals who appear healthy. He said that, in contrast to lifestyle
modification for which there is little evidence, drug treatment of high
blood pressure and high cholesterol, along with low-dose aspirin, has
been shown to work. But Professor McInnes conceded that “the absolute
benefit in very healthy people is small”, and a lot of people need
to be treated.
Dr Maxwell said that individual patients need to be involved in treatment
decisions but that communicating complex issues of risk is a challenge.
He explained that the science of medicine needs to be put into the context
of patient-centred issues, and added that one thing was clear: “We
have to do better in terms of patient empowerment and communicating risks.” |
The
Pharmaceutical Journal
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