# Patients' preferences for secondary prevention following a coronary event

## TL;DR

Patients with heart disease prefer lifestyle changes over drugs to improve health, focusing on physical activity, weight, and stress.

## Contribution

Reveals patient preferences for lifestyle over drug therapy in coronary disease prevention.

## Key findings

- Patients identified 'physical inactivity' more than medical records indicated.
- 87% preferred lifestyle changes over drug use if effective.
- Professional support was requested for physical inactivity, overweight, and stress.

## Abstract

•Patients’ risk factor perception markedly differs from their medical records.•Patients rate ‘physical inactivity’ as most applicable and important to improve.•Patients prefer improving lifestyle above drug therapy intensification.•Integrating patient preferences may facilitate personalised treatment decisions.

Patients’ risk factor perception markedly differs from their medical records.

Patients rate ‘physical inactivity’ as most applicable and important to improve.

Patients prefer improving lifestyle above drug therapy intensification.

Integrating patient preferences may facilitate personalised treatment decisions.

Despite clear evidence on the effectiveness of secondary prevention, patients with coronary artery disease frequently fail to reach guideline-based risk factor targets. Integrating patients’ preferences into treatment decisions has been recommended to reduce this gap. However, this requires knowledge about patient treatment preferences. Therefore, through a survey study, we aimed to explore which risk factors patients self-perceived, prioritised for improvement, and needed support with after a recent hospitalisation for coronary heart disease.

A digital questionnaire was presented to patients > 18 years recently discharged (≤3 months) from an acute coronary care unit in the Netherlands (Europe). Patients could select from eight cardiovascular risk factors that they (1) self-perceived, (2) prioritised for improvement, and (3) needed support to improve. Patients’ perceived risk factors were compared to those documented in the medical records.

Respondents (N = 254, 26 % women), mean age 64 (SD 10) years, identified ‘physical inactivity’ more frequently than their medical records (140 patients vs. 91 records, p < 0.001), while three other risk factors were reported with equal and four with lower frequency. ‘Physical inactivity’, ‘overweight’ and ‘stress’ were most frequently prioritised for improvement (82 %, 88 % and 78 %) and professional support (64 %, 50 % and 58 %), with 87 % preferring lifestyle optimisation if this would reduce drug use.

Patients with a recent coronary event show significant disparities in identifying risk factors compared to their medical records. They tend to prefer improving lifestyle- over drug-modifiable risk factors, particularly physical inactivity, overweight and stress, and indicate the need for support in improving these factors.