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      Online health information behaviour and its association with statin adherence in patients with high cardiovascular risk: A prospective cohort study

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          Abstract

          Objective

          Statins are effective for preventing cardiovascular disease. However, many patients decide not to take statins because of negative influences, such as online misinformation. Online health information may affect decisions on medication adherence, but measuring it is challenging. This study aimed to examine the associations between online health information behaviour and statin adherence in patients with high cardiovascular risk.

          Methods

          A prospective cohort study involving 233 patients with high cardiovascular risk was conducted at a primary care clinic in Malaysia. Participants used a digital information diary tool to record online health information they encountered for 2 months and completed a questionnaire about statin necessity, concerns and adherence at the end of the observation period. Data were analysed using structural equation modelling.

          Results

          The results showed that 55.8% (130 of 233 patients) encountered online health information. Patients who actively sought online health information (91 of 233 patients) had higher concerns about statin use ( β = 0.323, p = 0.023). Participants with higher concern about statin use were also more likely to be non-adherent ( β = -0.337, p < 0.001). Patients who actively sought online health information were more likely to have lower statin adherence, mediated by higher concerns about statin use (indirect effect, β = -0.109, p = 0.048).

          Conclusions

          Our results suggest that patients with higher levels of concern about statins may be actively seeking online information about statins, and their concerns might influence how they search, what they find, and the potential to encounter misinformation. Our study highlights the importance of addressing patients’ concerns about medications to improve adherence.

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          Most cited references56

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          The theory of planned behavior

          Icek Ajzen (1991)
          Organizational Behavior and Human Decision Processes, 50(2), 179-211
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            The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.

            Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalizability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover 3 main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors, to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. Eighteen items are common to all 3 study designs and 4 are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available at http://www.annals.org and on the Web sites of PLoS Medicine and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies.
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              2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease

              Circulation
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                Author and article information

                Journal
                Digit Health
                Digit Health
                DHJ
                spdhj
                Digital Health
                SAGE Publications (Sage UK: London, England )
                2055-2076
                21 March 2024
                Jan-Dec 2024
                : 10
                : 20552076241241250
                Affiliations
                [1 ]Department of Primary Care Medicine, Faculty of Medicine, Ringgold 37447, universityUniversiti Malaya; , Kuala Lumpur, Malaysia
                [2 ]Department of Research, Ringgold 68752, universitySingHealth Polyclinics; , Singapore, Singapore
                [3 ]Ringgold 121579, universityDuke-NUS Medical School; , Singapore, Singapore
                [4 ]Department of Social and Preventive Medicine, Faculty of Medicine, Ringgold 37447, universityUniversiti Malaya; , Kuala Lumpur, Malaysia
                [5 ]Biomedical Informatics and Digital Health, Faculty of Medicine and Health, School of Medical Sciences, Ringgold 4334, universityThe University of Sydney; , Sydney, Australia
                Author notes
                [*]Hooi Min Lim, Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia. Email: hmlim@ 123456ummc.edu.my
                Author information
                https://orcid.org/0000-0003-2481-9363
                https://orcid.org/0000-0002-8320-1603
                https://orcid.org/0000-0003-1545-7110
                Article
                10.1177_20552076241241250
                10.1177/20552076241241250
                10956144
                38515614
                e8597f4f-99e7-44e7-b5ea-e5cc20a5f98a
                © The Author(s) 2024

                This article is distributed under the terms of the Creative Commons Attribution 4.0 License ( https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 15 January 2024
                : 5 March 2024
                Funding
                Funded by: World Health Organization, FundRef https://doi.org/10.13039/100004423;
                Award ID: World Health Organisation (WHO) award (APWEMER)
                Categories
                Original Research Article
                Custom metadata
                ts19
                January-December 2024

                consumer health informatics,information-seeking behaviour,health literacy,medication adherence,cardiovascular risk

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