Comparing Patient and Physician Risk Tolerance for Bleeding Events Associated with Anticoagulants in Atrial Fibrillation—evidence from the United States and Japan

Okumura, Ken; Inoue, Hiroshi; Yasaka, Masahiro; Gonzalez, Juan Marcos; Hauber, A. Brett; Levitan, Bennett; Yuan, Zuyi; Brière, J

doi:10.1016/j.vhri.2015.03.016

Cited by 19 publications

(18 citation statements)

References 22 publications

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“…Multicountry studies took place in Norway and Denmark, 33 the USA and Canada, 31 the Netherlands and Belgium, 32 France, Germany, Italy, Spain and the UK 35 and Japan and the USA. 34 One study required participants to complete the DCE twice, once with assistance and once at home soon after 53 ; this was entered as both interview and self-complete via post Five studies 9 35 39 54 67 included separate DCEs for the HCP and non-HCP populations; the numbers of attributes for each DCE were entered independently. DCE, discrete choice experiment; HCP, healthcare professional.…”

Section: Resultsmentioning

confidence: 99%

“…Multicountry studies took place in Norway and Denmark, 33 the USA and Canada, 31 the Netherlands and Belgium, 32 France, Germany, Italy, Spain and the UK 35 and Japan and the USA. 34 …”

Section: Resultsmentioning

confidence: 99%

“…The most common analytical methods used were the random-effects probit, 36 43 44 46 48 50 51 56 64 65 67 the logit/conditional logit, 33 37 47 57 60 62 66 random-effects logit, 34 40 52 63 multinomial logit 32 35 39 49 53 or mixed logit, 9 42 55 59 with five studies using a range of other methods. 31 38 45 54 58 …”

Section: Resultsmentioning

confidence: 99%

“…The majority of studies (n=34) reported accounting for heterogeneity within samples; this was most commonly analysed using subgroups 32 33 37 38 44 47 50–53 56 58 60 62 63 66 67 or incorporating respondent information as covariates in the model. 9 31 43 59 64 In other studies, heterogeneity was accounted for by allowing random parameters in the model to be estimated 34 40 or using a heteroskedastic condition logit model. 60 One study reported that heterogeneity in preferences existed because the mean coefficient for a physician was non-significant, but the SD for the point estimate was significant.…”

Section: Resultsmentioning

confidence: 99%

“…Where coefficients were compared, ranking attributes based on the strength of coefficients 9 35 37–40 42–49 60 62 64 65 67 was the most frequently used method, although there were also approaches based on the difference between coefficients themselves or the CIs of coefficients. 32 51 An alternative approach to comparing results was to first estimate coefficients on a common scale, using marginal rates of substitution (eg, using a payment vehicle like willingness to pay, 36 38 54 willingness to accept risk 34 55 or time), 33 relative importance 52 63 or some weighting of the model coefficients, 59 and then making a comparison of these. One study calculated a ratio of the importance of patient and physician coefficients.…”

Section: Resultsmentioning

confidence: 99%

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Do patients and health care providers have discordant preferences about which aspects of treatments matter most? Evidence from a systematic review of discrete choice experiments

et al. 2017

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ObjectivesTo review studies eliciting patient and healthcare provider preferences for healthcare interventions using discrete choice experiments (DCEs) to (1) review the methodology to evaluate similarities, differences, rigour of designs and whether comparisons are made at the aggregate level or account for individual heterogeneity; and (2) quantify the extent to which they demonstrate concordance of patient and healthcare provider preferences.MethodsA systematic review searching Medline, EMBASE, Econlit, PsycINFO and Web of Science for DCEs using patient and healthcare providers. Inclusion criteria: peer-reviewed; complete empiric text in English from 1995 to 31July 2015; discussing a healthcare-related topic; DCE methodology; comparing patients and healthcare providers.DesignSystematic review.ResultsWe identified 38 papers exploring 16 interventions in 26 diseases/indications. Methods to analyse results, determine concordance between patient and physician values, and explore heterogeneity varied considerably between studies. The majority of studies we reviewed found more evidence of mixed concordance and discordance (n=28) or discordance of patient and healthcare provider preferences (n=12) than of concordant preferences (n=4). A synthesis of concordance suggested that healthcare providers rank structure and outcome attributes more highly than patients, while patients rank process attributes more highly than healthcare providers.ConclusionsDiscordant patient and healthcare provider preferences for different attributes of healthcare interventions are common. Concordance varies according to whether attributes are processes, structures or outcomes, and therefore determining preference concordance should consider all aspects jointly and not a binary outcome. DCE studies provide excellent opportunities to assess value concordance between patients and providers, but assessment of concordance was limited by a lack of consistency in the approaches used and consideration of heterogeneity of preferences. Future DCEs assessing concordance should fully report the framing of the questions and investigate the heterogeneity of preferences within groups and how these compare.

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Section: Resultsmentioning

confidence: 99%

“…Multicountry studies took place in Norway and Denmark, 33 the USA and Canada, 31 the Netherlands and Belgium, 32 France, Germany, Italy, Spain and the UK 35 and Japan and the USA. 34 …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Do patients and health care providers have discordant preferences about which aspects of treatments matter most? Evidence from a systematic review of discrete choice experiments

et al. 2017

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Benefit–Risk Assessments of Medical Treatments

Levitan

DiSantostefano

Evans

2019

Pharmacoepidemiology

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Patient Preferences for Oral Anticoagulation Therapy in Atrial Fibrillation: A Systematic Literature Review

Wilke

Bauer

Mueller

et al. 2016

Patient

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Objectives Since the introduction of non-vitamin K antagonist (VKA) oral anticoagulants (NOACs), an additional treatment option, apart from VKAs, has become available for stroke prevention in patients with atrial fibrillation (AF). For various reasons, it is important to consider patients' preferences regarding type of medication, particularly in view of the established relationship between preferences towards treatment, associated burden of treatment, and treatment adherence. This review aimed to systematically analyse the scientific literature assessing the preferences of AF patients with regard to long-term oral anticoagulant (OAC) treatment. Methods We searched the MEDLINE, Scopus and EMBASE databases (from 1980 to 2015), added records from reference lists of publications found, and conducted a systematic review based on all identified publications. Outcomes of interest included any quantitative information regarding the opinions or preferences of AF patients towards OAC treatment, ideally specified according to different clinical or convenience attributes describing different OAC treatment options. Results Overall, 27 publications describing the results of studies conducted in 12 different countries were included in our review. Among these, 16 studies analysed patient preferences towards OACs 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 certain threshold in stroke risk reduction could be reached. Nevertheless, most of the publications also showed that the preferences of AF patients towards OACs may differ from the perspective of clinical guidelines or the perspective of physicians. The remaining 11 studies included in our review assessed the preferences of AF patients towards specific OAC medication options, namely NOACs versus VKAs. 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 the need for bridging and frequent blood controls. Conclusion Stroke risk reduction and a moderate increase in the risk of bleeding are the most important attributes for an AF patient when deciding whether they are for or against OAC treatment. If different anticoagulation options have similar clinical characteristics, convenience attributes matter to patients. In this review, AF patients favour attribute levels that describe NOAC treatment.

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Comparing Patient and Physician Risk Tolerance for Bleeding Events Associated with Anticoagulants in Atrial Fibrillation—evidence from the United States and Japan

Cited by 19 publications

References 22 publications

Do patients and health care providers have discordant preferences about which aspects of treatments matter most? Evidence from a systematic review of discrete choice experiments

Do patients and health care providers have discordant preferences about which aspects of treatments matter most? Evidence from a systematic review of discrete choice experiments

Benefit–Risk Assessments of Medical Treatments

Patient Preferences for Oral Anticoagulation Therapy in Atrial Fibrillation: A Systematic Literature Review

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