Candidate card · General practice
You are a GP. The patient, aged 58, had a routine health check. Their total cholesterol is 7.1 mmol/L and their 10-year cardiovascular risk is 18%. You want to recommend a statin alongside lifestyle changes.
Task
- Explain the blood test result and what the cardiovascular risk means.
- Find out the patient’s views on taking medication.
- Explain the benefits and possible side effects of a statin.
- Discuss lifestyle changes that can lower the risk.
- Agree a plan, including follow-up.
Preparation: 3 minutes · Role-play: about 5 minutes
What to expect from the patient
- The patient has read that statins cause muscle damage and memory problems and would rather “try diet first”.
- Their father had a heart attack at 60, which they mention only if asked about family history.
Sample phrases for each stage
Explaining
“An 18% risk means that out of 100 people with results like yours, about 18 would have a heart attack or stroke in the next ten years.”
Exploring
“It sounds as though you have some concerns about statins. What have you heard about them?”
Informing
“Muscle aches can happen, but serious muscle problems are rare. If you did notice aching, we’d review the dose or try a different statin.”
Shared decision
“Diet and exercise are really important, and I’d encourage them either way. Given your level of risk, though, I’d recommend doing both. How do you feel about that?”
Closing
“Let’s check your cholesterol and liver test again in three months and see how you’re getting on.”
Common mistakes on this card
- Quoting percentages without explaining what they mean for this patient.
- Arguing with the patient’s sources instead of exploring their concerns.
- Forgetting to ask about family history, which changes the risk discussion.
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