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Patient factors considered by GP
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- patients who don’t understand the numbers (‘blank look on face’)
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- bring up numbers if patient is higher risk or risk not well controlled/ managed
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- numbers assumed to be less helpful for less educated/literate patients
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- patients who are interested in the science/evidence (males, highly educated)
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- patients who will get stuck in a long discussion of the numbers rather than focusing on what they can do
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- use numbers to justify treatment/no treatment for borderline patients
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- withhold absolute risk from highly anxious and low risk patients
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- gamblers more familiar with probability
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Descriptions of risk
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- risk level: low/negative risk, medium/moderate risk, high/severe/positive/increased risk
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- absolute risk % (probability of a heart attack or stroke in the next 5 or 10 years)
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- multiple risk factors: coexisting, mounting up, exponential
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- convert absolute risk % into a frequency (e.g. 1 in 8 people like you)
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- scenarios: future cardiac event, being ill for a prolonged period, explain in terms of patient’s life (e.g. family member who had CVD event)
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- change in absolute risk % if risk factors reduced
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- analogies: compare to other risks
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- relative risk for particular populations (diabetics, high risk ethnicity)
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- compare individual risk factor results to guideline targets
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Communication tools
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- position on colour-coded absolute risk chart (red = high risk, green = low risk)
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- absolute risk calculator to show current/future risk and effect of risk factors
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- images (e.g. cholesterol spikes, what the brain looks like during a stroke, coronary artery to show relationship between high cholesterol and heart attack)
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