Physician and Patient Preferences for Oral Anticoagulation Therapy Decision-Making in Atrial Fibrillation: Results from a National Best-Worst Scaling Survey in Turkey (PREF-AF)

Speaker(s)

Kilickesmez K1, Aras D2, Degertekin M3, Ozer N4, Hacibedel B5, Helvacioglu K6, Koc U5, Olmez A5, Ergene O7
1Cemil Taşcıoğlu Research and Training Hospital, Istanbul, Turkey, 2Medipol University Hospital, Istanbul, Turkey, 3Yeditepe University, Istanbul, Turkey, 4Hacettepe University, Ankara, Turkey, 5Pfizer Pharmaceuticals, Istanbul, Turkey, 6Pfizer Pharmaceuticals, İstanbul, Turkey, 7Dokuz Eylül University, İzmir, Turkey

Presentation Documents

OBJECTIVES: Atrial fibrillation (AF) is the most common cardiac dysrhythmia and a common cause of ischemic stroke. Stroke prevention with oral anticoagulation (OAC) is the cornerstone of AF management. The objective of this study was to quantify the relative importance that patients and physicians in Turkey place on different OAC attributes when making treatment decisions in AF.

METHODS: A cross-sectional survey was administered to AF patients (≥50 years) receiving OAC and practising cardiologists, including residents with ≥2 years of experience in Turkey. Object-case best-worst scaling (BWS) was used to assess the relative importance of 10 OAC characteristics including stroke prevention, bleeding risks, need for monitoring, availability of reversal agent, and administration-related characteristics. Relative importance was estimated as the proportion of overall importance. Surveys were administered between October 2021 and February 2022.

RESULTS: For both patients (N=230; 50% male) and physicians (N=194; 74% male), the most important attributes for OAC treatment decision-making in AF were “success in preventing stroke” (57% and 73.9% or overall importance, respectively) and “risk of major bleeding” (20% and 23.4%, respectively). For patients, other attributes were much less important, but not altogether unimportant: reversal agent availability (7%), monitoring (5%), food or drug interactions (3%), minor bleeding (3%), and ease of swallowing (2%). For physicians, among the other attributes, only the need for monitoring (1.3%) had relative importance of >1%.

CONCLUSIONS: For all Turkish participants, efficacy and safety were found to be the most important attributes influencing OAC choice in AF with these two attributes accounting for 77% and 97.3% of overall importance for patients and physicians, respectively. Certain considerations, especially reversal agent availability and monitoring appear to be more important to patients than to physicians This is the first study to use BWS to quantify patient and physician preferences for OAC treatments in AF in Turkey.

Code

PCR239

Topic

Patient-Centered Research, Study Approaches

Topic Subcategory

Stated Preference & Patient Satisfaction, Surveys & Expert Panels

Disease

SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory)