Table 3.
Summary table
| RELIANCE | Fields of agreement | |
|---|---|---|
| Too difficult and inappropriate to give the patient a numerical estimate of cardiovascular risk or risk score; more important to treat hypertension than hyperlipidaemia pharmaceutically; lifestyle intervention is more important for younger people; reduced drug prices influence prescribing criteria; individualization of advice and treatment is necessary; testing and prescribing drugs without proper indication can make patients feel ill | ||
| Fields of variation | ||
| 1. Trust in pharmaceutical prevention | A. Firm trust in effectiveness and cost-effectiveness of pharmaceutical prevention | |
| B. Some doubts about the effectiveness for the individual patient | ||
| C. Expressed doubts due to insufficient evidence | ||
| 2. Trust in non-pharmaceutical prevention | A. Non-pharmaceutical treatment is the basis | |
| B. Non-pharmaceutical treatment is too difficult to carry out and not very effective | ||
| C. Non-pharmaceutical treatment is not effective and it impairs the quality of life for the patients | ||
| 3. Importance of a treatment goal | A. A pre-defined target is necessary | |
| B. The importance of a target is varying: important for high-risk patients but not for low-risk patients | ||
| C. The lowering of blood-pressure or lipids is the most important, not to a certain value | ||
| 4. Pharmaceutical prevention for different ages | A. More important for younger individuals | |
| B. Equally important for young and old | ||
| C. More important for older individuals | ||
| RESPONSIBILITY | Fields of agreement | |
| Genetic disposition is a significant risk factor; the "western" lifestyle causes cardiovascular disease; smoking is the most important lifestyle risk factor; a positive expectation that the intervention is beneficial is a necessary condition for compliance | ||
| Fields of variation | ||
| 1. Information regarding potential adverse effects and length of treatment | A. Important to inform for the patient to be prepared and feel safe | |
| B. Avoiding information is better, not to worry the patient | ||
| 2. Treatment decision | A. The doctor has the main responsibility | |
| B. A decision on equal terms is preferred | ||
| C. The patient has the main responsibility | ||
| 3. The role of the doctor in non-pharmaceutical treatment | A. The doctor's role is to confront the patient with uncomfortable recommendations and make demands on the patient | |
| B. The doctor's role is to communicate a positive message and encourage every little step the patient takes towards a healthier lifestyle | ||
| C. It is too difficult for the doctor to talk about lifestyle risk factors without blaming or burdening the patient. The doctor has no important role in non-pharmaceutical treatment | ||
| D. The doctor has no right to demand a change in the patient's lifestyle, but should instead prescribe pharmaceuticals for smokers and over-weight people | ||