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Updated: Jan 20, 2026
Attitudes: Explicit and Implicit Attitudes
Role of risk attitude and time preference in preventive aspirin use adherence
Jingrong Zhu1,2, Yunfeng Shi1, Jinlin Li1
1School of Management and Economics, Beijing Institute of Technology, Beijing, China.
Insights
Patients with risk-seeking behaviors and greater impatience were less likely to start or adhere to aspirin therapy for cardiovascular disease (CVD) prevention. Understanding these factors can improve treatment adherence.
Area of Science:
- Cardiovascular Disease Prevention
- Behavioral Economics
- Health Psychology
Background:
- Medication adherence for chronic cardiovascular disease (CVD) prevention remains a significant challenge.
- Poor adherence negatively impacts patient outcomes and healthcare systems.
Purpose of the Study:
- To investigate how risk attitudes and time preferences influence patient decisions regarding initiating and adhering to aspirin therapy for CVD prevention.
Main Methods:
- Survey of 357 patients using low-dose aspirin for CVD prevention.
- Elicitation of risk attitudes and time preferences via a multiple price list experiment.
- Logistic regression analysis to identify predictors of aspirin use adherence.
Main Results:
- Risk-seeking behavior was linked to lower participation and compliance with aspirin therapy (P < .01 and P < .05, respectively).
- Higher impatience (time preference) was associated with a reduced likelihood of initiating aspirin use (P < .05).
- Forgetfulness, lack of knowledge, and insufficient belief in aspirin's efficacy were key contributors to poor adherence.
Conclusions:
- Identifying patients with risk-seeking tendencies and those who discount the future significantly can aid in developing personalized adherence strategies.
- Tailored interventions based on individual risk attitudes and time preferences may enhance patient adherence to aspirin therapy for CVD prevention.
Background:
Poor adherence to medication that is taken chronically for the prevention of cardiovascular disease (CVD) continues to occur. Poor adherence is a primary barrier to treatment success and affects not only the patient but also the health care system.
Objective:
We aim to explore the impacts of risk attitudes and time preferences on the decisions of patients to begin and comply with aspirin therapy for CVD prevention.
Methods:
Three hundred fifty-seven patients who used low-dose aspirin for CVD prevention under the guidance of their doctors completed the survey. The risk attitudes and time preferences of the patients were elicited using a multiple price list experiment. Logistic regression models were used to examine the predictors of adherence to aspirin use.
Results:
Risk-seeking behaviours were significantly associated with both nonparticipation (P < .01) and lower compliance (P < .05) in patients. The coefficient for time preference was only significant at the 0.05 level for the decision to initiate aspirin use, which indicated that more impatient patients were less likely to begin with the use of aspirin. Forgetfulness in using aspirin on time and a lack of knowledge (as well as a lack of belief in the use of aspirin) could largely explain the poor adherence to aspirin therapy.
Conclusions:
The identification of risk seekers and of those individuals who discount the future to a lesser degree may help providers to formulate tailored strategies to their patients, thus effectively enhancing their adherence to treatment.
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