Evidence map›Paper›PMID 37463339›Full record

ArticleFamily practice2025

Statins for primary prevention in multimorbid patients: to prescribe or not to prescribe? A qualitative analysis of general practitioners' decision-making processes.

Racha Onaisi, Anaïs Bezzazi, Thomas Berthouin, Justine Boulet, Jennifer Hasselgard-Rowe, Hubert Maisonneuve

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Article in Family practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Racha OnaisiDepartment of General Practice, University of Bordeaux, F-33000 Bordeaux, France.ORCID 0000-0002-4357-2530
Anaïs BezzaziUniversity College of General Medicine, University Claude Bernard Lyon 1, Lyon, France.
Thomas BerthouinUniversity College of General Medicine, University Claude Bernard Lyon 1, Lyon, France.
Justine BouletUniversity College of General Medicine, University Claude Bernard Lyon 1, Lyon, France.
Jennifer Hasselgard-RoweInstitute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland.ORCID 0000-0001-7578-8777
Hubert MaisonneuveUniversity College of General Medicine, University Claude Bernard Lyon 1, Lyon, France.ORCID 0000-0002-5276-1122

Funding

University of Geneva
6 · The paper itself

Abstract

introductionA better understanding of the determinants involved in general practitioners' (GPs) decision-making processes when it comes to prescribing statins as primary prevention in patients with multimorbidity could provide insights for improving implementation of primary prevention guidelines.

methodsWe conducted a qualitative study using a deductive framework-based and inductive analysis of GPs' semi-structured interviews verbatim, from which expertise profiles of prescribers were also drawn. The analytical framework was built from a pragmatic synthesis of the evidence-based medicine, Modelling using Typified Objects (MOT) model of clinical reasoning processes, Theoretical Domains Framework, and shared decision-making frameworks.

resultsFifteen GPs were interviewed between June 2019 and January 2020. Diabetes seemed to represent a specific motivation for deciding about statin prescription for primary prevention purposes; and in situations of multimorbidity, GPs differentiated between cardiovascular and non-cardiovascular multimorbidity. Expert prescribers seemed to have integrated the utilisation of cardiovascular risk calculation scores throughout their practice, whereas non-expert prescribers considered them difficult to interpret and preferred using more of a "rule of thumb" process. One interviewee used the risk calculation score as a support for discussing statin prescription with the patient.

conclusionOur results shed light on the reasons why statins remain under-prescribed for primary prevention and why non-diabetic multimorbid patients have even lower odds of being prescribed a statin. They call for a change in the use of risk assessment scores, by placing them as decision aids, to support and improve personalised shared decision-making discussions as an efficient approach to improve the implementation of recommendations about statins for primary prevention.

Indexed as

Cardiovascular DiseasesClinical Decision-MakingGeneral PractitionersHydroxymethylglutaryl-CoA Reductase InhibitorsPractice Patterns, Physicians'Primary PreventionAdultDecision MakingFemaleHumansInterviews as TopicMaleMiddle AgedMultimorbidityQualitative ResearchHydroxymethylglutaryl-CoA Reductase Inhibitorscardiovascular preventionclinical reasoningdecision aiddecision makingshared decision makingstatin

Identifiers

PMID37463339
PMCPMC12014902

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.