Patient values and preferences for antithrombotic therapy in atrial fibrillation

Loewen, Peter; Ji, Tianshu Angela; McClean, Alison R

doi:10.1160/th16-10-0787

Cited by 41 publications

(28 citation statements)

References 69 publications

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“…Views of patients should also be central to decision‐making around choice of oral anticoagulants. A systematic review of patients' values and preferences for DOACs versus warfarin generated heterogeneous findings, highlighting the need for focusing on patients' individual values and preferences . A further systematic review reported that stroke risk reduction and a moderate increase in the risk of bleeding were the most important attributes for patients when deciding between DOACs and warfarin .…”

Section: Discussionmentioning

confidence: 99%

A systematic review of clinicians' views and experiences of direct‐acting oral anticoagulants in the management of nonvalvular atrial fibrillation

Generalova

Cunningham

Leslie

et al. 2018

Brit J Clinical Pharma

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Section: Discussionmentioning

confidence: 99%

A systematic review of clinicians' views and experiences of direct‐acting oral anticoagulants in the management of nonvalvular atrial fibrillation

Generalova

Cunningham

Leslie

et al. 2018

Brit J Clinical Pharma

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“…We assessed patients from the five European countries that have the largest population sizes, which resulted in an underrepresentation of Eastern and Northern Europe countries. We intentionally did not include attributes related to probability of stroke and bleeding in our attribute set because we were interested in the tradeoff between convenience attributes and feared they would be dominated by effectiveness and safety concerns, as was shown earlier [8,9], but it would be very interesting to study whether there are different classes of patients with regard to the trade-off between benefit, risk, and convenience.…”

Section: Limitationsmentioning

confidence: 99%

“…Several recent studies addressed preference for anticoagulant therapy in patients with AF. To most patients, reducing stroke and bleeding risk is most important [8,9], but most DOACs have similar benefit-risk profiles on a population level. DOACs differ mostly from VKAs in convenience attributes (e.g., intake frequency, regular coagulation monitoring, or drug/food interaction) [10].…”

Section: Introductionmentioning

confidence: 99%

“…DOACs differ mostly from VKAs in convenience attributes (e.g., intake frequency, regular coagulation monitoring, or drug/food interaction) [10]. With regard to convenience of treatment, once-daily intake and no need for regular coagulation monitoring were found to be the most important attributes of anti-coagulation therapy; however, there is considerable heterogeneity in patient preference [8,9]. Heterogeneity in preference may be attributed to differences in sociodemographic characteristics, currently used anti-coagulation therapy, and preference elicitation method.…”

Section: Introductionmentioning

confidence: 99%

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Heterogeneity in Preferences for Anti-coagulant Use in Atrial Fibrillation: A Latent Class Analysis

Til

Oudshoorn-Groothuis

Weernink

et al. 2020

Patient

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Introduction Recent reviews on patients' preferences towards attributes of oral anti-coagulant therapy have shown that preference for convenience of therapy is heterogeneous. In this study, we used a novel approach-latent class analysis (LCA)-to assess heterogeneity. Methods We developed a health preference survey that consisted of 12 discrete choice questions. The following attributes of convenience were included: intake frequency; need for regular coagulation monitoring; diet or drug interactions; relation between medication and food intake; and pill type. Background questions about gender, age, current therapy [i.e., directacting oral anti-coagulant (DOAC) or vitamin K antagonist (VKA)], self-reported medication adherence, and pill burden were included. Mixed logit analysis (MLA) and LCA were performed. The scale-adjusted LCA model with two scale classes and four preference classes emerged as the model with the best fit and interpretability. Results A total of 508 patients with non-valvular atrial fibrillation from five European countries (Germany, Italy, Spain, France, and the UK) were surveyed in August 2017. The most important attributes were need for monitoring (37%) and intake frequency (27%). Patient preferences were significantly influenced by country, gender, and current anti-coagulant therapy. Four different preference classes of patients were identified in the LCA. First, most patients (57%) were in the "no need for regular coagulation monitoring" class. Current DOAC users and patients who were the least adherent to therapy were more likely to prefer no coagulation monitoring. Second, 20% of patients were in the "balanced" class of patients. Current VKA users with moderate adherence were more likely to be in this class. Patients who reported the lowest adherence were most likely in the "once daily, interactions likely" class (16%). Fourth, current VKA users and highly adherent patients were most likely to prefer therapies with a need for regular coagulation monitoring (7%). Conclusions This study demonstrated significant preference heterogeneity among patients with atrial fibrillation and linked these preferences to differences in background characteristics. Country of residence and currently prescribed therapy influenced patient preferences in both the MLA and LCA models.

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“…Patient perspectives are important, and most patients place great emphasis on stroke prevention although adherence to treatment efforts require emphasis and implementation 48,49 .…”

Section: Accepted Manuscriptmentioning

confidence: 99%

The Importance and Future of Population Screening for Atrial Fibrillation

Shin

Lip

2018

Canadian Journal of Cardiology

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Patient values and preferences for antithrombotic therapy in atrial fibrillation

Cited by 41 publications

References 69 publications

A systematic review of clinicians' views and experiences of direct‐acting oral anticoagulants in the management of nonvalvular atrial fibrillation

A systematic review of clinicians' views and experiences of direct‐acting oral anticoagulants in the management of nonvalvular atrial fibrillation

Heterogeneity in Preferences for Anti-coagulant Use in Atrial Fibrillation: A Latent Class Analysis

The Importance and Future of Population Screening for Atrial Fibrillation

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