Abstract 17106: Impact of Communication Format and Risk Horizon on Patient Perceptions of CVD Risk: Findings From the PALM Registry
Background: Engaging patients in decision making regarding cardiovascular disease (CVD) prevention requires patients to understand their CVD risk, but optimal formats for communicating CVD risk are unclear.
Methods: The PALM (Patient and Provider Assessment of Lipid Management) Registry is a cross sectional registry of patients at risk for CVD or with prior CVD seen across 138 US cardiology, endocrinology, and primary care clinics (May-Sept 2015). Patients were asked to consider a hypothetical scenario where they were told they had a 10-year CVD risk of 15%, and to rate how high they perceived this risk to be. Patients were randomized to receive the risk estimate without a visual aid or with a bar graph or a pictogram (100 smile/frown faces). The scenario was then changed to present the same risk but as the corresponding SCORE (4% 10-year risk of death) and lifetime risk (50% lifetime risk) estimates. Responses were compared by risk horizon and graphical format.
Results: Of 3060 respondents with mean age 66 years, 10.5% were African American and 54.8% male. Patients (n=3,060) were more likely to report that they perceived risk as “high or very high” when presented with lifetime CVD risk (72.6%) than 10-year CVD risk (32.1%, p<0.001 vs. lifetime risk) or CV death risk (25.6% p<0.001 vs. lifetime risk). When risk was presented as a pictogram, risk perceptions were lower across all three risk time horizons than when presented as a bar graph or without graphics (Figure).
Conclusion: Changes in how CVD risk is presented alters the way patients interpret risk severity, which may affect willingness to engage in prevention strategies. Presenting risk with pictograms decreases the perceived severity of risk. Effective risk communication tools should consider both what risk scores are used and also how risk is displayed.
Author Disclosures: A.M. Navar: Consultant/Advisory Board; Modest; Regeneron and Sanofi Pharmaceuticals. Research Grant; Significant; Regeneron and Sanofi. T.Y. Wang: Research Grant; Modest; Gilead Sciences, Eli Lilly, Daiichi Sanyo, Astra Zeneca, Boston Scientific, Regeneron, GlaxoSmithKline. Honoraria; Modest; Astra Zeneca, Eli Lilly, Pfizer. P. Zakroysky: None. S. Li: None. A.C. Goldberg: Research Grant; Modest; Amarin, Amgen, Pfizer, Merck, Sanofi/Regeneron, ISIS, Genzyme/ISIS, and Arisaph. Consultant/Advisory Board; Modest; Optum Rx, Sanofi/Regneron. J.G. Robinson: Research Grant; Significant; Amarin, Amgen, Astra-Zeneca, Eli Lilly, Esai, Glaxo-Smith Kline, Merck, Pfizer, Regeneron Pharmaceuticals, Inc., Takeda, Sanofi. Consultant/Advisory Board; Modest; Akcea/Ionis, Merck, Eli Lilly, Esperion. Consultant/Advisory Board; Significant; Amgen, Pfizer, Regeneron Pharmaceuticals, Inc., Sanofi. V.L. Roger: None. S.S. Virani: None. P.W. Wilson: None. L. Lee: Employment; Significant; Sanofi. J. Elassal: Employment; Significant; Regeneron. E.D. Peterson: Research Grant; Significant; Janssen Pharmaceutical Products. Consultant/Advisory Board; Modest; Janssen Pharmaceutical Products, Regeneron Pharmaceuticals Inc, Sanofi-Aventis. Consultant/Advisory Board; Significant; AstraZeneca, Bayer Corporation US, Boehringer Ingelheim, Merck & Co, Valeant.
- © 2016 by American Heart Association, Inc.