PATIENT PREFERENCES REGARDING ORAL ANTICOAGULANTS- RESULTS OF A DISCRETE CHOICE EXPERIMENT IN SPANISH PATIENTS WITH ATRIAL FIBRILLATION TREATED WITH VITAMIN-K ANTAGONISTS
Author(s)
Müller S1, Henry M2, Hemmrich M2, Osorio Fernandez G3, Marín F4, Anguita M5, Badimon L6, Ferreira I7
1Ingress-Health HWM GmbH, Wismar, Germany, 2Bayer AG, Berlin, Germany, 3Bayer Hispania, S.L., Barcelona, Spain, 4Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain, 5Hospital Universitario Reina Sofía, Córdoba, Spain, 6Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, 7Hospital Universitari Vall d’Hebron, Barcelona, Spain
OBJECTIVES Oral anticoagulation is pivotal in the management of thromboembolic risk in non-valvular atrial fibrillation (NVAF) patients. An effective anticoagulation therapy also relates on good medication adherence to achieve good anticoagulation control. One key element for reaching or sustaining a good adherence and persistence is to prescribe treatments that patients prefer. The objective of this study was to elucidate patient preferences regarding attributes that describe different anticoagulation alternatives. METHODS A multi-center discrete choice experiment (DCE) was conducted in Spain. Study sites enrolled patients aged 18+ years with NVAF, who initiated a Vitamin-K antagonist (VKA) treatment. The DCE design considered four treatment attributes: need of bridging (yes/no), interactions with food/alcohol (yes/no), need of regular international normalized ratio (INR) assessments/blood controls and subsequent dose adjustment (yes/no) and frequency of intake (once/twice daily). Distance to treating practitioner represented a neutral attribute to express patients’ overall utility in terms of a comprehensible unit. Conditional logit regression model was applied to estimate patients’ utility for each attribute and to evaluate the influence of different levels on the probability of a patient of choosing a specific OAC alternative. RESULTS In total, 286 patients were included (mean age: 72.9 years, 42.0% female, mean CHA2DS2-VASc: 3.2). Patients preferred an anticoagulation treatment option characterized by “no need for bridging” (β=0.530, p<0.001), “no need for regular INR controls” (β=0.652, p<0.001), “less interactions with food/alcohol” (β=0.503, p<0.001) and “once daily intake” (β=0.360, p<0.001). To receive such a treatment option compared to a treatment that offers none of the favourable characteristics, the average patient would be willing to travel additional 57 kilometres to the treating practitioner. CONCLUSIONS In our study, NVAF patients currently treated with VKA showed a strong preference for features that characterize non-VKA anticoagulation options.
Conference/Value in Health Info
2019-11, ISPOR Europe 2019, Copenhagen, Denmark
Code
PCV127
Topic
Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes, Stated Preference & Patient Satisfaction
Disease
Cardiovascular Disorders