Measuring unmet preventive medication needs and socio-demographic characteristics of respondents at high risk of primary cardiovascular events in the UK household population 2010-2012


Jakob Petersen

unmet needs, cardiovascular diseases, primary prevention, community healthcare, public health, lifestyle risk factors, prescription medicines, drug non-adherence, non-consultation, household population surveys

Despite of progress in the last decade the family of cardiovascular diseases (CVD) remains one of the main causes of premature death and disability in the UK. The gains made could furthermore be jeopardised due to rising levels of obesity and diabetes observed in ever younger cohorts. The government set out the new CVD Outcome Strategy in 2013 to improve CVD prevention, treatment pathways and long-term care. This re-emphasises the need for early detection of those at high risk and interventions to mitigate individual risk factors through lifestyle advice and preventive long-term medication. The present study uses the UK longitudinal household study, Understanding Society, which offers opportunities to study health status, socio-demographic and lifestyle factors in a community setting. More than 15,000 adult respondents of Understanding Society took part in a health assessment in the period 2010-2012 and just over 5,800 of those were aged 40-74 years, gave a blood sample and did not report to have been diagnosed with CVD or diabetes. Ten-year risk of first CVD event will be calculated for this group using the Joint British Societies 2 risk prediction tool (initially without and later with blood test results). Based on recent predictions the sample size for the study is expected to reach 1,200. The possession of anti-hypertensive and lipid-regulating prescription drugs will be studied against current clinical treatment guidelines. Multivariable logistic regression analysis will be used to characterise socio-demographic and lifestyle factors associated with unmet preventive medication needs among participants with a high 10-year risk of a CVD event. Two groups that are likely to emerge are those that are undiagnosed due to non-consultation and those no longer in possession of adequate medication due to non-adherence. More knowledge about the risk factors for non-consultation and non-adherence would be of interest to planners of public health interventions.