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Understanding the concept of medical risk reduction: A comparison between the UK and Germany

Objective: To explore the views of German general practitioners, healthcare assistants, and laypeople about the minimum absolute risk reduction needed to justify drug treatment to prevent heart attacks, and to compare these views with those found in the UK. Method: Qualitative content analysis study using the same clinical risk scenario and semi-structured interview schedule concerning a “pill” reducing cardiovascular risk as a recent UK study. The similarly recruited participants included six general practitioners (GPs), four healthcare assistants, and 12 laypeople, interviewed in 10 GP surgeries, two community settings, and five private homes. Results: In both countries, most participants, health professionals as well as laypeople, used risk numbers inconsistently in preventive treatment decisions. In Germany, some people explicitly rejected the probabilistic risk concept as a basis for such decisions. In the UK, people were generally more aware of cost for society than in Germany. Other factors were similar in both countries. Conclusion: In both countries, preventive risk information is not well understood. Our results suggest that this is not only a technical communication problem.