Preferences Regarding The Attributes Of Oral Anticoagulants In Patients With Atrial Fibrillation Results Of A Discrete Choice Experiment

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Preferences Regarding The Attributes Of Oral Anticoagulants In Patients With Atrial Fibrillation Results Of A Discrete Choice Experiment
Autor Böttger B, Thate-Waschke IM, Bauersachs R, Kohlmann T, Thomas Wilke
In: Value in Health
Ausgabe 17(7)
ISBN/ISSN:
Erscheinungsjahr 2014
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OBJECTIVES

Since the introduction of new oral anticoagulants (NOACs), an additional option for stroke prevention of patients with atrial fibrillation (AF) compared to vitamin-K-antagonists (VKAs) is available. The objective of this study was to asses patients’ preferences regarding the attributes of these different treatment options.

METHODS

We conducted a multicenter study among randomly selected physicians. Preferences were assessed by computer-assisted telephone interviews. We used a Discrete-Choice-Experiment (DCE) with four treatment dependent attributes (need of bridging: yes/no, interactions with food/nutrition: yes/no, need of INR controls/dose adjustment: yes/no; frequency of intake: once/twice daily) and one comparator attribute (distance to practitioner: [lt]1km/[gt]15km). Preferences measured in the interviews were analyzed descriptively and based on a logistic regression model.

RESULTS

A total of 140 AF patients (age: 74.0±8.5 years; 57.0% male; mean CHA2DS2-VASc: 6.1±1.1; current medication: 27.1% Rivaroxaban, 71.4% VKA, 1.4% other) could be interviewed. Regardless of type of medication, patients significantly preferred the attributes’ level (in order of patients’ importance) “once daily intake” (Level: once = 1 vs. twice = 0; Coefficient = 0.954; p[lt]0.001), “no interactions with food/nutrition” (yes = 1 vs. no = 0; -0.842; p[lt]0.001), “no bridging necessary” (yes = 1 vs. no = 0; -0.656; p[lt]0.001) and “distance to practitioner of ≤ 1 km ([gt] 15 km =1 vs. ≤ 1 km = 0; 0.644; p[lt]0.001). However, for the attribute "need of INR controls/dose adjustment" (Level: yes = 1 vs. no = 0; Coefficient = 0.020; p=0.808) no significant preference in favour of one of the options are shown.

CONCLUSION

In our analyses, “once daily frequency of intake” was the most important attribute for patients’ choice followed by “no interactions with food/nutrition” and “no bridging necessary”. Thus, patients with AF seem to prefer treatment options which are easier to administer. When deciding about medical therapy, patients’ preferences should be considered.