CHARACTERISTICS INFLUENCING JAPANESE ATRIAL FIBRILLATION PATIENTS PREFERENCES FOR ANTICOAGULANTS USE
Author(s)
Okumura K1, Inoue H2, Yasaka M3, Gonzalez JM4, Hauber AB4, Iwamoto K5, Wang ECY6, Rossi B5, Briere JB71Hirosaki University Graduate School of Medicine, Hirosaki, Japan, 2University of Toyama School of Medicine, Toyama, Japan, 3Kyushu Medical Center, Fukuoka, Japan, 4RTI Health Solutions, Research Triangle Park, NC, USA, 5Bayer Yakuhin, Ltd., Kita-ku, Osaka, Japan, 6Bayer Yakuhin, Ltd., Tokyo, Japan, 7Bayer Yakuhin, Ltd., Chiyoda-ku, Tokyo, Japan
BACKGROUND: Although effective for stroke prevention in atrial fibrillation (AF), anticoagulants increase the risk of bleeding. The relative importance of benefits and risks associated with anticoagulants is influenced by various factors and has mostly been documented only in physicians. OBJECTIVES: To identify patients characteristics influencing the relative importance of non-fatal outcomes associated with anticoagulants. METHODS: Data from a choice-format conjoint survey asking AF patients to choose between hypothetical anticoagulants were used to estimate importance weights for non-fatal outcomes associated with anticoagulants. The influence of patients characteristics was tested by evaluating the significance of interactions between importance weights and age, gender, prior use of anticoagulants, personal history of stroke, family history of stroke and personal or family history of bleeding. RESULTS: A total of 152 patients completed the survey. Only two patients characteristics significantly influenced the relative importance of non-fatal outcomes associated with anticoagulants. Overall, the least desirable non-fatal outcome was disabling stroke. Using disabling stroke as a reference, patients characteristics such as prior use of anticoagulants increased the relative importance of non-disabling stroke by 48%, major extra-cranial bleeding by 12% and non-major clinically relevant bleeding by 82%. On the other hand, personal or family history of bleeding increased the relative importance of major extra-cranial bleeding by 19% and non-major clinically relevant bleeding by 34% while decreasing the relative importance of non-disabling stroke by 15%. CONCLUSIONS: This study documents the impact of patients prior experience on relative importance of non-fatal outcomes associated with anticoagulants. Proper explanation of the benefits and risks of anticoagulants may play a role in patients understanding and acceptance of stroke prophylactic treatment. Interestingly, no single patients characteristics changed the fact that AF patients were willing to accept a non-zero risks of bleeding in exchange for prevention of disabling strokes.
Conference/Value in Health Info
2012-11, ISPOR Europe 2012, Berlin, Germany
Value in Health, Vol. 15, No. 7 (November 2012)
Code
PCV102
Topic
Patient-Centered Research
Topic Subcategory
Stated Preference & Patient Satisfaction
Disease
Cardiovascular Disorders, Respiratory-Related Disorders
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