CHOLESTEROL-LOWERING THERAPY - WHAT PATIENTS EXPECT IN RETURN

Objective: To assess variability in patients' values and preferences r egarding cholesterol-lowering therapy. Design: A descriptive study. Pa tients currently receiving cholesterol-lowering therapy were interview ed using the time tradeoff and standard reference gamble techniques of utility assessment. Setting: Internal medicine clinics of a military medical center. Participants: Thirty-five patients, clinically free of coronary disease, receiving cholesterol-lowering therapy for at least three months. Results: When the time tradeoff method was applied, 12 (34%) of the patients indicated that less than one month of additional life would be a fair return for adhering to their current therapy for the rest of their lives, while 13 (37%) patients required more than o ne additional year of life, and four (11%) required at least five year s. By the standard reference gamble method, 18 (51%) patients would no t have accepted a risk of one in a thousand of imminent death (in 30 d ays) in hopes of obtaining a normal life expectancy off therapy, while 14 (40%) would have agreed to a 1% or greater risk in order to avoid therapy. Conclusions: While many patients apparently expected very lit tle in return for adhering to therapy, many others may not be getting ''what they bargained for. ''