[Factors associated with the opinion of hypercholesterolemic patients on the duration of their treatment. Results of the FRACTION study]. / Facteurs associés à l'opinion des patients hypercholestérolémiques sur la durée de leur traitement. Résultats de l'enquête FRACTION.

ABSTRACT

INTRODUCTION: The treatment of hypercholesterolemia is regularly limited by non compliance over the long-term. Studies conducted on the subject underline the interest of considering compliance as a behaviour composed of multiple determinants that require better knowledge. The patients' opinion concerning the severity and evolution of their health problem, as well as the use and duration of their treatment, are, in this context, essential. OBJECTIVES: Based on the hypothesis that hypercholesterolemic patients who believe that their problem only requires short-term treatment are "candidates" for poor compliance, we attempted to identify the factors that determine their opinion on the duration of treatment. METHODS: 1595 files of hypercholesterolemic patients, who had participated in a survey describing how they represented cholesterol and its impact on their health (the FRACTION study), were analyzed. Two groups of opposing opinion on the duration of treatment for hypercholesterolemia (limited or prolonged) were formed. Their socio-demographic and clinical characteristics and the way they represented their health were compared. The factors predicting their opinion on the duration of treatment were identified. RESULTS: The opinion that only short-term treatment was required was associated with younger age, lower education, the fact of not (or not yet) being treated pharmacologically, personal experience of the disease (presence of hypertension, cardiovascular family history or perception of diminished health), little correct knowledge on cholesterol and hypercholesterolemia and greater erroneous beliefs or prejudice with regard to treatment. After adjustment to the socio-demographic and clinical factors, many representations of health continue to predict the opinion in favor of short-term treatment. CONCLUSION: This study demonstrates, for the first time, the importance of knowledge on health, beliefs and personal judgement that are among the determinating factors of patients' opinion on the duration of their treatment. It shows the justification of their individual approach to compliance, behaviour highly influenced by the representation each patient has of his health. It emphasizes the interest of personalizing educative messages addressed to hypercholesterolemic patients, by taking into better account the potential factors of resistance to compliance.