Many older people are forgoing medications that offer only average heart attack prevention, turned off by the prospect of side effects that include fatigue, nausea and fuzzy thinking, according to Yale School of Medicine researchers.
“These patients are willing to take medications for cardiovascular disease prevention, but only if they are not linked to what are generally considered to be acceptable side effects,” said first author Terri Fried, M.D., professor of internal medicine/geriatrics at Yale School of Medicine.
Typically, clinical practice guidelines recommend giving patients preventative medications based on his or her risk for developing an illness and the likelihood that the medication will reduce that risk. However, the researchers suspected that this might not be how the patients, themselves, weigh the pros and cons of medicine.
The team set out to evaluate older patients’ willingness to take a preventative medication for cardiovascular disease based on its benefits and harms. The researchers held face-to-face interviews with 356 people (aged 65 and older) residing in the community.
When volunteers were asked about their willingness to take medication for primary prevention of heart attack (myocardial infarction), most (88 percent) said they would take the medication if it had no negative side effects and if it gave about the average risk reduction of currently available medications.
On the other hand, many participants (48 to 69 percent) were unwilling or uncertain about receiving such medication if it caused mild fatigue, nausea, or fuzzy thinking. Furthermore, only 3 percent would accept medication with adverse effects severe enough to interfere with daily functioning.
“Our results show that these ‘side effects,’ more aptly considered as adverse events, are as important to older persons as the medication’s benefits, and need to be considered important outcomes in their own right,” said Fried.
The report is published online in the Archives of Internal Medicine.
Source: Yale University