Patient Preferences for Nonvitamin K Antagonist Oral Anticoagulants in Stroke Prevention: A Multicountry Discrete Choice Experiment.
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ABSTRACT: Purpose
The patient's perspective is becoming increasingly important in clinical and policy decisions. This study examined atrial fibrillation (AF) patient preferences for different characteristics of nonvitamin K antagonist oral anticoagulants (NOACs).Methods
A discrete choice experiment (DCE) addressing AF patients treated with NOACs in France, Germany, and the United Kingdom was conducted. The DCE included the following attributes: frequency of administration (once/twice daily), size of tablet/capsule (6-9 mm/20 mm), meal-related intake (intake with food required/independent), and distance to treating physician (1 km/10 km). Preferences were analyzed based on a conditional logit regression model.Results
In total, 758 patients (males: 57.3%; mean age: 71.4 years) with an average disease duration of 5.5 years were included (apixaban/dabigatran/edoxaban/rivaroxaban: 34.0%/14.5%/6.6%/44.9%, respectively). Patients preferred NOAC treatment options characterized by once-daily dosing regimens (42.8%; p < 0.001), shorter distance to treating physicians (25.0%; p < 0.001), a small-sized tablet (21.5%; p < 0.001), and intake independent of food (10.6%; p < 0.001).Conclusions
Patients primarily prefer a once-daily NOAC regimen. Individual preferences should be considered for the treatment of AF patients as this may result in improved treatment adherence and consequently better effectiveness and safety in routine clinical practice.
SUBMITTER: Wilke T
PROVIDER: S-EPMC6935812 | biostudies-literature | 2019
REPOSITORIES: biostudies-literature
Publications
Patient Preferences for Nonvitamin K Antagonist Oral Anticoagulants in Stroke Prevention: A Multicountry Discrete Choice Experiment.
Wilke Thomas T Meinecke Anna-Katharina AK Schaefer Bernhard B Buchwald Sandra S Eriksson Daniel D Müller Sabrina S
Cardiology research and practice 20191218
<h4>Purpose</h4>The patient's perspective is becoming increasingly important in clinical and policy decisions. This study examined atrial fibrillation (AF) patient preferences for different characteristics of nonvitamin K antagonist oral anticoagulants (NOACs).<h4>Methods</h4>A discrete choice experiment (DCE) addressing AF patients treated with NOACs in France, Germany, and the United Kingdom was conducted. The DCE included the following attributes: frequency of administration (once/twice daily ...[more]
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Project description:ObjectiveThe objective was to investigate the extent to which treatment benefits, risks and costs affected parturients' preferences for labor analgesia.MethodsWe recruited 248 healthy parturients prior to labor at an antenatal ward and administered a discrete choice experiment survey. Parturients were asked to choose among four hypothetical forms of labor analgesia: epidural analgesia, pethidine, Entonox and no analgesia, which were defined by: pain score, duration of second stage of labor, risks of instrumental delivery, back pain and permanent nerve injury, and out-of-pocket cost. We used mixed logit model to calculate the relative importance of each attribute (out of 100).ResultsParturients preferred receiving labor analgesia over not receiving analgesia and those who had positive past experience with epidural preferred epidural over other modalities. Out-of-pocket cost (28%), duration of second stage of labor (26%) and pain score following treatment (18%) were the most important attributes.ConclusionOut-of-pocket cost was a major concern. Parturients prioritized having lower pain and shorter labor experience over risks associated with epidural analgesia. Parturients should be presented with realistic range of risks of side-effects so that they can decide how to balance risks against benefits and costs associated with child labor.
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