Presentation (CTI)

OBJECTIVES: To identify patient-prioritized characteristics of warfarin models of care that influence patient preference, informing the development of a discrete choice experiment.
METHODS: Semi-structured interviews were conducted with patients and multidisciplinary clinicians experienced in different warfarin care models. Interviews explored experiences, preferences, and concerns regarding warfarin management. An iterative process of data collection and thematic analysis was employed, with interviews continuing until data saturation was reached. Emergent themes and subthemes were translated into candidate attributes for future discrete choice experiment development.
RESULTS: Fifteen in-depth interviews were conducted (5 clinicians and 10 patients). Patients consistently prioritized prevention of thromboembolism, followed by bleeding avoidance, though concern levels varied by experience. Convenience emerged as a major theme, particularly the travel requirement, which was critical for those with limited transportation or mobility. Patients were generally willing to undergo frequent INR monitoring for reassurance, whereas clinicians perceived that patients would find frequent testing burdensome. Patients desired to be involved in warfarin management decisions while relying on clinicians as a safety net. Awareness of self-testing and self-management was limited among patients. Clinicians considered INR stability and insurance coverage before recommending these options. Additionally, the availability of self-testing and self-management strategies was limited across healthcare settings.
CONCLUSIONS: Key patient-valued attributes of warfarin care models include clinical outcomes, convenience, monitoring frequency, and clinician relationship. Discrepancies between patients’ and clinicians’ perspectives underscore the need to integrate patient preferences into warfarin management. These findings will inform attribute selection for discrete choice experiment development.