Patients' responses to the communication of vascular risk in primary care: a qualitative study

To examine the perspectives of patients identified as being at 'high risk' of cardiovascular events, with particular reference to the potential responses to risk messages.

Systematic population screening for cardiovascular disease (CVD) aims to identify those at high risk and provide medication and lifestyle support. In the United Kingdom, this takes the form of the National Health Service Health Check.

We conducted a qualitative interview study. In 2011 we interviewed 37 patients, from seven UK primary care practices, who were at high risk of developing CVD.

Risk messages were delivered via face-to-face consultations or by letter and were relayed in either a 'downplaying' or 'serious warning' style. Patients' accounts of receiving information about risk revealed two broad response styles: 'committed' (active resistance; commitment to change) and 'non-committed' (procrastination; downplaying and fatalism). Responses to risk messages are usually assumed to be due to individual characteristics but they may be explained by an interaction between the way risk is communicated and the patient's response style.