Danish citizens' perspectives on the preventive medication recommended after screen‐detected cardiovascular disease: A qualitative study

Background The rationale for screening for cardiovascular disease (CVD) is debated as a prevention strategy. However, research shows that when preventive medication is initiated after screening for CVD, mortality rates decrease, especially among men. When implementing screening programmes, facilitat...

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Published in:Scandinavian journal of caring sciences 2024-09, Vol.38 (3), p.802-814
Main Authors: Højgaard, Helen Gräs, Frederiksen, Kirsten, Høgh, Annete Langager, Rasmussen, Bodil, Dahl, Marie
Format: Article
Language:English
Subjects:
Autonomy
Cardiovascular disease
Cardiovascular diseases
Citizens
Clinical medicine
decision making
Drugs
early interventiong
Health care
Interviews
Medical personnel
Medical screening
medication adherence
Mortality rates
Prevention
qualitative study
screening
Significant others
Uncertainty
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Summary:Background The rationale for screening for cardiovascular disease (CVD) is debated as a prevention strategy. However, research shows that when preventive medication is initiated after screening for CVD, mortality rates decrease, especially among men. When implementing screening programmes, facilitating citizens' informed decisions and empowering their autonomy in the decision‐making process are crucial. We therefore aimed to explore citizens' perspectives on and decisions regarding initiating cardiovascular preventive medication for screen‐detected CVD. Methods We employed an exploratory qualitative design using semi‐structured interviews to investigate participants' perspectives on and decisions regarding initiating cardiovascular preventive medication for screen‐detected CVD. Twelve interviews were conducted and analysed using thematic analysis following Braun and Clarke's six‐step approach. Findings We found one overall theme, Being on a continuum between wellness and illness, with two underlying sub‐themes. Sub‐theme (1) Navigating mixed feelings and pathways reflects participants' perspectives on CVD preventive medication, which were positioned on a continuum with shifting perspectives. The state between wellness and illness was experienced as liminal and characterised by uncertainty and concerns about CVD risk. (2) Navigating medication decisions: a negotiated process. Pivotal medical decisions hinged on trust in authorities or own judgement, influenced by attitudes towards the need for medication, perception of meaningfulness, asymptomatic condition, age, family responsibility and predisposition. Participants' medical decisions were supported and impacted by significant others. Conclusion We uncovered a continuum of shifting perspectives ranging from feeling improved health to experiencing fear of CVD. For certain citizens, it is like navigating between these contrasting feelings. The perceived necessity and meaningfulness, in particular, shape medical decisions. Providing support for informed decisions is crucial and includes significant others. Shared decision‐making with healthcare professionals as facilitators is needed. Future research is warranted to investigate how to embrace the various perspectives on initiating CVD preventive medication in clinical practice.
ISSN:0283-9318
1471-6712
1471-6712
DOI:10.1111/scs.13274