Denise Ann Taylor1, Katharine Wallis2,3, Sione Feki4, Sione Segili Moala4, Manusiu He-Naua Esther Latu5, Elizabeth Fono Fanueli5, Padmapriya Priya Saravanakumar6, Sue Wells2. 1. Victoria University of Wellington, School of Nursing Midwifery and Health Practise, Bath, New Zealand Denise.Taylor@vuw.ac.nz. 2. University of Auckland, General Practice, Auckland, New Zealand. 3. University of Queensland medical School, Prmary Care Clinical Unit, Rockhampton, Australia. 4. Waitemata District Health Board, Pacific Health Portfolio Manager, Takapuna, New Zealand. 5. The University of Auckland Faculty of Medical and Health Sciences, Population Health, Auckland, New Zealand. 6. Auckland University of Technology, Health, Auckland, New Zealand.
Abstract
BACKGROUND: Despite cardiovascular disease (CVD) risk prediction equations becoming more widely available for people aged 75 years and over, views of older people on CVD risk assessment are unknown. AIM: To explore older people's views on CVD risk prediction and its assessment. DESIGN AND SETTING: Qualitative study of community dwelling older New Zealanders. METHODS: We purposively recruited a diverse group of older people. Semi-structured interviews and focus groups were conducted, transcribed verbatim and thematically analysed. RESULTS: Thirty-nine participants (mean age 74 years) of Māori, Pacific, South Asian and European ethnicities participated in one of 26 interviews or three focus groups. Three key themes emerged, (1) Poor knowledge and understanding of cardiovascular disease and its risk assessment, (2) Acceptability and perceived benefit of knowing and receiving advice on managing personal cardiovascular risk; and (3) Distinguishing between CVD outcomes; stroke and heart attack are not the same. Most participants did not understand CVD terms but were familiar with 'heart attack,' 'stroke' and understood lifestyle risk factors for these events. Participants valued CVD outcomes differently, fearing stroke and disability which might adversely affect independence and quality of life, but being less concerned about a heart attack, perceived as causing less disability and swifter death. These findings and preferences were similar across ethnic groups. CONCLUSION: Older people want to know their CVD risk and how to manage it, but distinguish between CVD outcomes. To inform clinical decision making for older people, risk prediction tools should provide separate event types rather than just composite outcomes.
BACKGROUND: Despite cardiovascular disease (CVD) risk prediction equations becoming more widely available for people aged 75 years and over, views of older people on CVD risk assessment are unknown. AIM: To explore older people's views on CVD risk prediction and its assessment. DESIGN AND SETTING: Qualitative study of community dwelling older New Zealanders. METHODS: We purposively recruited a diverse group of older people. Semi-structured interviews and focus groups were conducted, transcribed verbatim and thematically analysed. RESULTS: Thirty-nine participants (mean age 74 years) of Māori, Pacific, South Asian and European ethnicities participated in one of 26 interviews or three focus groups. Three key themes emerged, (1) Poor knowledge and understanding of cardiovascular disease and its risk assessment, (2) Acceptability and perceived benefit of knowing and receiving advice on managing personal cardiovascular risk; and (3) Distinguishing between CVD outcomes; stroke and heart attack are not the same. Most participants did not understand CVD terms but were familiar with 'heart attack,' 'stroke' and understood lifestyle risk factors for these events. Participants valued CVD outcomes differently, fearing stroke and disability which might adversely affect independence and quality of life, but being less concerned about a heart attack, perceived as causing less disability and swifter death. These findings and preferences were similar across ethnic groups. CONCLUSION: Older people want to know their CVD risk and how to manage it, but distinguish between CVD outcomes. To inform clinical decision making for older people, risk prediction tools should provide separate event types rather than just composite outcomes.