PATIENT PREFERENCES FOR ORAL ANTICOAGULATION THERAPY IN ATRIAL FIBRILLATION- A SYSTEMATIC LITERATURE REVIEW
Author(s)
Wilke T1, Bauer S2, Mueller S2, Kohlmann T3, Bauersachs R4
1IPAM, Wismar, Germany, 2Ingress-Health HWM GmbH, Wismar, Germany, 3University Medicine Greifswald, Greifswald, Germany, 4Department of Vascular Medicine, Klinikum Darmstadt, Darmstadt, Germany
OBJECTIVES: The objective of this study was to systematically analyze the scientific literature assessing atrial fibrillation (AF) patients’ preferences with regard to long-term oral anticoagulation (OAC) treatment. METHODS: We searched Medline, Scopus, Embase (1980-2015) and added records from reference lists of publications found. Outcomes of interest included any quantitative information about AF patient opinions or preferences towards OAC treatment. RESULTS: We included 27 publications describing results of studies conducted in 12 different countries. Among these, 16 studies analyzed patient preferences towards OAC in general. These studies predominantly assessed which benefits (mainly, lower stroke risk) AF patients would require to tolerate harms (mainly, higher bleeding risk) associated with an OAC. Most studies showed that patients were willing to accept higher bleeding risks if a stroke risk reduction is reached (2-4 major bleeds for 1 prevented stroke accepted). Most of the publications additionally showed that AF patient preferences towards OAC may differ from the perspective of clinical guidelines or the perspective of physicians.The remaining 11 included studies assessed AF patient preferences towards specific OAC medication options, namely NOACs versus VKAs. Here, our review showed that AF patients prefer easy-to-administer treatments, such as treatments that are applied once daily without any food/drug interactions and without a need for bridging and frequent blood controls. CONCLUSIONS: Stroke risk reduction and a moderate bleeding risk increase are the most important attributes for an AF patient’s decision for or against OAC treatment. If different anticoagulation options have similar clinical characteristics, convenience attributes matter to patients. Here, AF patients favour attribute levels that describe NOAC treatment.
Conference/Value in Health Info
2017-05, ISPOR 2017, Boston, MA, USA
Value in Health, Vol. 20, No. 5 (May 2017)
Code
PCV78
Topic
Patient-Centered Research
Topic Subcategory
Stated Preference & Patient Satisfaction
Disease
Cardiovascular Disorders