‘Patients’ and health professionals’ attitudes and perceptions towards the initiation of preventive drugs for primary prevention of cardiovascular disease: a systematic review of qualitative studies’

Research output: Contribution to journalArticlepeer-review

Colleges, School and Institutes


Background: Statins and antihypertensive agents are recommended for primary prevention of cardiovascular disease but are not always prescribed to eligible patients.

Design and setting: Systematic review of qualitative studies.

Aim: To explore health professionals’ and patients’ attitudes towards cardiovascular preventive drugs.

Methods: MEDLINE, EMBASE, PsychINFO, CINAHL, ASSIA, HMIC, Conference Proceedings Citation Index and Open Grey were searched for studies of qualitative design without restrictions on date or language. Two reviewers performed study selection, data extraction, quality assessment and thematic synthesis.

Results: 2,585 titles and abstracts were screened yielding 27 studies of which 5 met eligibility criteria on full text assessment. These included 62 patients and 47 health professionals. Five themes emerged about patient attitudes: questioning preventive drugs; perceived benefit and risks such as improving quality of life; patient preferences; trust in health professional judgement; and family, friends and media influences. Five themes emerged about health professional attitudes: addressing patient concerns and information; duty as a health professional to prescribe; uncertainty about preventive drug prescribing; recognising consequences of prescribing such as unnecessary medicalisation; and personalised treatment.

Conclusion: The attitudes of patients and health professionals regarding drug initiation for primary prevention reflect the complexity of the patient-health professional encounter in primary practice. For prescribing to be more adherent to guidelines, research should further investigate the patient-health professional relationship and the appropriate communication methods required when discussing drug initiation specifically for primary prevention.


Original languageEnglish
JournalBJGP Open
Publication statusPublished - 7 Apr 2020


  • Qualitative, cardiovascular disease, statins, antihypertensive drugs, primary prevention

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