Patients' responses to risk information about the benefits of treating hypertension

The medical profession is often presented with information on the value of treatment in terms of likely risk reduction. If this same information was presented to patients--so enabling them to give proper informed consent--would this affect their decision to be treated?

To examine patients' choice about treatment in response to different forms of risk presentation.

Postal questionnaire study.

The questionnaire was sent to 102 hypertensive patients and 207 matched non-hypertensive patients aged between 35 and 65 years in a UK general practice.

Patients were asked the likelihood, on a four-point scale, of their accepting treatment for a chronic condition (mild hypertension) on the basis of relative risk reduction, absolute risk reduction, number needed to treat, and personal probability of benefit.

An 89% response rate was obtained. Of these, 92% would accept treatment using a relative risk reduction model, 75% would accept treatment using an absolute risk reduction model, 68% would accept treatment using a number needed to treat model, and 44% would accept treatment with a personal probability of benefit model.

Many patients may prefer not to take treatment for mild hypertension if the risks were fully explained. However, given that the form of the explanation has a strong influence on the patient's decision, it is not clear how decision-making can be fully shared nor what should constitute informed consent to treatment in this situation.