Both benefits and adverse effects influence elderly's adherence to cardiovascular medication

The willingness of the elderly to take medication for primary cardiovascular disease prevention is relatively insensitive to its benefit but highly sensitive to its adverse effects, according to a recent study published in the Archives of Internal Medicine.

Investigators interviewed 356 community-living elderly. Participants were asked about their willingness to take medication for the primary prevention of myocardial infarction (MI) according to its benefits (absolute 5-year risk reduction) and varying harms in terms of type and severity of adverse effects.

Among the participants, 88% were willing to take the medication if the benefit approximated the average risk reduction of currently available medications (an absolute benefit of 6 fewer persons with MI out of 100). Of the participants who would take the medication, 82% remained willing to do so if the absolute benefit was decreased to 3 fewer patients with MI; 17% of patients who would not take the medication changed their preference if the absolute benefit was increased to 10 fewer patients with MI.

Conversely, 48% to 69% of participants were unwilling or uncertain about taking medication with average benefit causing mild fatigue, nausea, or fuzzy thinking. When medication caused adverse effects severe enough to affect functioning, only 3% were willing to take it.

"These results suggest that clinical guidelines and decisions about prescribing these medications to older persons need to place emphasis on both their benefits and harms," concluded the authors.