Shared decisions: A qualitative study on clinician and patient perspectives on statin therapy and statin-associated side effects

Sarah T. Ahmed, Julia M. Akeroyd, Dhruv Mahtta, Richard Street, Jason Slagle, Ann Marie Navar, Neil J. Stone, Christie M. Ballantyne, Laura A. Petersen, Salim S. Virani

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

BACKGROUND: Despite guideline recommendations and clinical trial data suggesting benefit, statin therapy use in patients with atherosclerotic cardiovascular disease remains suboptimal. The aim of this study was to understand clinician and patient views on statin therapy, statin-associated side effects (SASEs), SASE management, and communication around statin risks and benefits. METHODS AND RESULTS: We conducted qualitative interviews of patients with atherosclerotic cardiovascular disease who had SASEs (n=17) and clinicians who regularly prescribe statins (n=20). We used directed content analysis, facilitated by Atlas.ti software, to develop and revise codebooks for clinician and patient interviews. The most relevant codes were “pile sorted” into 5 main topic domains: (1) SASEs vary in severity, duration, and time of onset; (2) communication practices by clinicians around statins and SASEs are variable and impacted by clinician time limitations and patient preconceived notions of SASEs; (3) although a “trial and error” approach to managing SASEs may be effective in allowing clinicians to keep patients with atherosclerotic cardiovascular disease on a statin, it can be frustrating for patients; (4) outside sources, such as the media, internet, social networks, and social circles, influence patients’ perceptions and often impact the risk benefit discussion; and (5) a decision aid would be beneficial in facilitating clinician decision-making around SASEs and discussion of SASEs with the patients. CONCLUSIONS: Statin use among patients with atherosclerotic cardiovascular disease remains suboptimal because of various patient-and clinician-related factors. The development of a decision aid to facilitate discussion of SASEs, clinician decisionmaking, and SASE management may improve statin use in this high-risk population.

Original languageEnglish (US)
Article numbere017915
JournalJournal of the American Heart Association
Volume9
Issue number22
DOIs
StatePublished - 2020
Externally publishedYes

Keywords

  • Atherosclerotic cardiovascular disease
  • Qualitative research
  • Statin-associated side effects
  • Statins

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Shared decisions: A qualitative study on clinician and patient perspectives on statin therapy and statin-associated side effects'. Together they form a unique fingerprint.

Cite this