04 Feb How Many Pills Are Patients Willing To Take To Prevent Disease?

MedicalResearch.com Interview with:
Robert Hutchins, M.D., M.P.H.
Department of Medicine, Division of General Internal Medicine
UCSF

Medical Research: What is the background for this study? What are the main findings?

Dr. Hutchins: “Utility” refers to the effect on quality of life that a certain intervention carries and a utility value generally varies from 0-1.0.  The more negative the effect is, the lower the utility value (closer to 0), and the less it affects quality of life, the closer to 1.0 it is.  On a theoretical scale, “perfect health” is 1.0 and death is 0.  There are a number of studies that — USE a utility value for taking pills, generally between 0.95 and 1.0.  However, many cost-effectiveness analyses ignore the utility value altogether, or arbitrarily choose 1.0 as the utility.  We found that a small change in the utility value can have a very large effect on the overall cost-effectiveness of an intervention.  We found that the utility value of taking pills, assessed by three different commonly used methods, to be 0.990-0.994, depending on the method.

Medical Research: What should clinicians and patients take away from your report?

Dr. Hutchins: The implications of our study are really more important for looking at populations.  There are obvious implications for individual physicians who prescribe medication for cardiovascular prevention for patients on a daily basis.  However, the most important results we found are that including an accurate utility value for taking pills into cost-effectiveness analyses can change the outcome of the study entirely.  We believe it also reinforces that beginning a medication (of any kind) should be a shared decision between provider and patient.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Hutchins: We would like to look more individually at why and how patients feel like taking pills for cardiovascular prevention affects their quality of life.  There are obvious reasons like having to remember it, paying for it (which we asked them to ignore for this study), the taste/smell/texture, etc.  But there were a handful of people whose responses did not line up with others, in general.  We would like to figure out, more qualitatively, why taking a pill has such a drastic effect on these people’s quality of life.

Citation:

Robert Hutchins, Anthony J. Viera, Stacey L. Sheridan, and Michael P. Pignone. Quantifying the Utility of Taking Pills for Cardiovascular Prevention. Circulation: Cardiovascular Quality and Outcomes, February 2015 DOI: 10.1161/CIRCOUTCOMES.114.001240

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MedicalResearch.com Interview with:, & Robert Hutchins, M.D., M.P. (2015). How Many Pills Are Patients Willing To Take To Prevent Disease? MedicalResearch.com

Last Updated on February 4, 2015 by Marie Benz MD FAAD