PDF herunterladen
Thromb Haemost 2017; 117(06): 1007-1022
DOI: 10.1160/TH16-10-0787
Review Article
Schattauer GmbH

Patient values and preferences for antithrombotic therapy in atrial fibrillation

A Narrative Systematic Review
Peter S. Loewen
1   Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, Canada
,
Angela Tianshu Ji
1   Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, Canada
,
Anita Kapanen
1   Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, Canada
,
Alison McClean
1   Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, Canada
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Received:15. Oktober 2016

Accepted after major revision: 23. Februar 2017

Publikationsdatum:
07. November 2017 (online)

    Lizenzen und Reprints

Summary

Guidelines recommend that patients’ values and preferences should be considered when selecting stroke prevention therapy for atrial fibrillation (SPAF). However, doing so is difficult, and tools to assist clinicians are sparse. We performed a narrative systematic review to provide clinicians with insights into the values and preferences of AF patients for SPAF antithrombotic therapy. Narrative systematic review of published literature from database inception. Research questions: 1) What are patients’ AF and SPAF therapy values and preferences? 2) How are SPAF therapy values and preferences affected by patient factors? 3) How does conveying risk information affect SPAF therapy preferences? and 4) What is known about patient values and preferences regarding novel oral anticoagulants (NOACs) for SPAF? Twenty-five studies were included. Overall study quality was moderate. Severe stroke was associated with the greatest disutility among AF outcomes and most patients value the stroke prevention efficacy of therapy more than other attributes. Utilities, values, and preferences about other outcomes and attributes of therapy are heterogeneous and unpredictable. Patients’ therapy preferences usually align with their values when individualised risk information is presented, although divergence from this is common. Patients value the attributes of NOACs but frequently do not prefer NOACs over warfarin when all therapy-related attributes are considered. In conclusion, patients’ values and preferences for SPAF antithrombotic therapy are heterogeneous and there is no substitute for directly clarifying patients’ individual values and preferences. Research using choice modelling and tools to help clinicians and patients clarify their SPAF therapy values and preferences are needed.

Supplementary Material to this article is available online at www.thrombosis-online.com.

Keywords

Atrial fibrillation - anticoagulation - antiplatelet - antithrombotic - stroke - bleeding - values - preferences - medication
 

  • References

  • 1 Hart RG. et al. Meta-analysis: Antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med 2007; 146: 857-867.
    CrossrefPubMedGoogle Scholar
  • 2 Connolly SJ. et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009; 361: 1139-1151.
    CrossrefPubMedGoogle Scholar
  • 3 Patel MR. et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 2011; 365: 883-891.
    CrossrefPubMedGoogle Scholar
  • 4 Granger CB. et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2011; 365: 981-992.
    CrossrefPubMedGoogle Scholar
  • 5 Giugliano RP. et al. Edoxaban versus Warfarin in Patients with Atrial Fibrillation. N Engl J Med 2013; 369: 2093-2104.
    CrossrefPubMedGoogle Scholar
  • 6 January CT. et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/ American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. Circulation 2014; 130: e199-267.
    CrossrefPubMedGoogle Scholar
  • 7 Skanes AC. et al. Focused 2012 Update of the Canadian Cardiovascular Society Atrial Fibrillation Guidelines: Recommendations for Stroke Prevention and Rate/Rhythm Control. Can J Cardiol 2012; 28: 125-136.
    CrossrefPubMedGoogle Scholar
  • 8 European Heart Rhythm Association. European Association for Cardio-Thoracic Surgery. Camm AJ. et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J 2010; 31: 2369-2429.
    CrossrefPubMedGoogle Scholar
  • 9 Lane DA. et al. Cardiac tachyarrhythmias and patient values and preferences for their management: the European Heart Rhythm Association (EHRA) consensus document endorsed by the Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE). Europace 2015; 17: euv233-1769.
    PubMedGoogle Scholar
  • 10 Institute of Medicine (US). Committee on Quality of Health Care in America. Crossing the quality chasm: A new health system for the 21st century. 2001
    PubMedGoogle Scholar
  • 11 Lane DA, Lip GYH. Barriers to Anticoagulation in Patients With Atrial Fibrillation: Changing Physician-Related Factors. Stroke 2007; 39: 7-9.
    PubMedGoogle Scholar
  • 12 Lane D. et al. Best Practice for Atrial Fibrillation Patient Education. Curr Pharmaceutical Des 2014; 21: 533-543.
    PubMedGoogle Scholar
  • 13 McCabe PJ. et al. Patients’ experiences from symptom onset to initial treatment for atrial fibrillation. J Clin Nursing 2015; 24: 786-796.
    CrossrefPubMedGoogle Scholar
  • 14 Roche-Nagle G. et al. Evaluation of patient knowledge regarding oral anticoagulants. Ir Med J 2003; 96: 211-213.
    PubMedGoogle Scholar
  • 15 Hu Y-F. et al. Identification and management of noncompliance in atrial fibrillation patients receiving dabigatran: the role of a drug monitor. PACE 2015; 38: 465-471.
    CrossrefPubMedGoogle Scholar
  • 16 Shore S. et al. Adherence to dabigatran therapy and longitudinal patient outcomes: insights from the veterans health administration. Am Heart J 2014; 167: 810-817.
    CrossrefPubMedGoogle Scholar
  • 17 Kimmel SE. et al. The influence of patient adherence on anticoagulation control with warfarin: results from the International Normalized Ratio Adherence and Genetics (IN-RANGE) Study. Arch Intern Med 2007; 167: 229-235.
    CrossrefPubMedGoogle Scholar
  • 18 Gorst-Rasmussen A. et al. Dabigatran adherence in atrial fibrillation patients during the first year after diagnosis: a nationwide cohort study. J Thromb Haemost 2015; 13: 495-504.
    CrossrefPubMedGoogle Scholar
  • 19 Cutler TW. et al. A retrospective descriptive analysis of patient adherence to dabigatran at a large academic medical centre. J Manag Care Spec Pharm 2014; 20: 1028-1034.
    PubMedGoogle Scholar
  • 20 Gomes T. et al. Persistence with therapy among patients treated with warfarin for atrial fibrillation. Arch Intern Med 2012; 172: 1687-1689.
    CrossrefPubMedGoogle Scholar
  • 21 Yao X. et al. Effect of Adherence to Oral Anticoagulants on Risk of Stroke and Major Bleeding Among Patients With Atrial Fibrillation. J Am Heart Assoc 2016; 5: e003074.
    CrossrefPubMedGoogle Scholar
  • 22 MacLean S. et al. Patient values and preferences in decision making for anti-thrombotic therapy: a systematic review: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141: e1S-23S.
    CrossrefPubMedGoogle Scholar
  • 23 Liberati A. et al. The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration. Ann Intern Med 2009; 151: W65-W94.
    PubMedGoogle Scholar
  • 24 PROSPERO – International prospective register of systematic reviews. crd.york.ac.uk. Available at: http://www.crd.york.ac.uk/prospero/ Accessed February 28, 2016
    PubMed
  • 25 Rokeach M. The nature of human values. 1973
    PubMedGoogle Scholar
  • 26 Schulz KF. et al. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. Br Med J 2010; 340: c332-2.
    CrossrefPubMedGoogle Scholar
  • 27 Elm von E. et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med 2007; 4: e296.
    CrossrefPubMedGoogle Scholar
  • 28 Tong A. et al. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care 2007; 19: 349-357.
    CrossrefPubMedGoogle Scholar
  • 29 Bridges JFP. et al. Conjoint Analysis Applications in Health–a Checklist: A Report of the ISPOR Good Research Practices for Conjoint Analysis Task Force. Value in Health 2011; 14: 403-413.
    CrossrefPubMedGoogle Scholar
  • 30 Stevanovic A. et al. CONSORT Item Reporting Quality in the Top Ten Ranked Journals of Critical Care Medicine in 2011: A Retrospective Analysis. Timmer A, editor. PLoS ONE 2015; 10: e0128061.
    PubMedGoogle Scholar
  • 31 Gage BF. et al. The effect of stroke and stroke prophylaxis with aspirin or warfarin on quality of life. Arch Intern Med 1996; 156: 1829-1836.
    CrossrefPubMedGoogle Scholar
  • 32 Protheroe J. et al. The impact of patients’ preferences on the treatment of atrial fibrillation: observational study of patient based decision analysis. Br Med J 2000; 320: 1380-1384.
    CrossrefPubMedGoogle Scholar
  • 33 Gage BF. Cost-effectiveness of warfarin and aspirin for prophylaxis of stroke in patients with nonvalvular atrial fibrillation. J Am Med Assoc 1995; 274: 1839-1845.
    CrossrefPubMedGoogle Scholar
  • 34 Gage BF. et al. Cost-effectiveness of preference-based antithrombotic therapy for patients with nonvalvular atrial fibrillation. Stroke 1998; 29: 1083-1091.
    CrossrefPubMedGoogle Scholar
  • 35 Robinson A. et al. How patients with atrial fibrillation value different health outcomes: a standard gamble study. J Health Serv Res Policy 2001; 6: 92-98.
    CrossrefPubMedGoogle Scholar
  • 36 LaHaye S. et al. Evaluation of patients’ attitudes towards stroke prevention and bleeding risk in atrial fibrillation. Thromb Haemost 2014; 111: 465-473.
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 37 Devereaux PJ. et al. Differences between perspectives of physicians and patients on anticoagulation in patients with atrial fibrillation: observational study. Br Med J 2001; 323: 1218-22.
    CrossrefPubMedGoogle Scholar
  • 38 Alonso-Coello P. et al. Values and preferences for oral antithrombotic therapy in patients with atrial fibrillation: physician and patient perspectives. Health Expectations 2014; 1-10.
    PubMedGoogle Scholar
  • 39 Wild D. et al. Patient perspectives on taking vitamin K antagonists: a qualitative study in the UK, USA and Spain. Expert Rev Pharmacoecon Outcomes Res 2009; 9: 467-474.
    CrossrefPubMedGoogle Scholar
  • 40 Man-Son-Hing M. et al. Warfarin for atrial fibrillation. The patient’s perspective. Arch Intern Med 1996; 156: 1841-1848.
    PubMedGoogle Scholar
  • 41 Ghijben P. et al. Preferences for oral anticoagulants in atrial fibrillation: a best-best discrete choice experiment. Pharmacoeconomics 2014; 32: 1115-1127.
    CrossrefPubMedGoogle Scholar
  • 42 Böttger B. et al. Preferences for anticoagulation therapy in atrial fibrillation: the patients’ view. J Thromb Thrombolysis 2015; 40: 406-415.
    CrossrefPubMedGoogle Scholar
  • 43 Shafrin J. et al. Physician and Patient Preferences for Nonvalvular Atrial Fibrillation Therapies. Value in Health 2016; 19: 451-459.
    CrossrefPubMedGoogle Scholar
  • 44 Okumura K. et al. Comparing Patient and Physician Risk Tolerance for Bleeding Events Associated with Anticoagulants in Atrial Fibrillation– evidence from the United States and Japan. Value Health Reg Issues 2015; 6: 65-72.
    PubMedGoogle Scholar
  • 45 Andrade JG. et al. Values and preferences of physicians and patients with nonvalvular atrial fibrillation who receive oral anticoagulation therapy for stroke prevention. Can J Cardiol 2016; 32: 747-753.
    CrossrefPubMedGoogle Scholar
  • 46 Palacio AM. et al. Patient values and preferences when choosing anticoagulants. Patient Prefer Adherence 2015; 9: 133-138.
    PubMedGoogle Scholar
  • 47 Sudlow M. et al. A community survey of patients with atrial fibrillation: associated disabilities and treatment preferences. Br J Gen Pract 1998; 48: 1775-1778.
    PubMedGoogle Scholar
  • 48 Attaya S. et al. Study of warfarin patients investigating attitudes toward therapy change (SWITCH Survey). Am J Ther 2012; 19: 432-435.
    CrossrefPubMedGoogle Scholar
  • 49 Hong C. et al. Validation of a patient decision aid for choosing between dabigatran and warfarin for atrial fibrillation. J Popul Ther Clin Pharmacol 2013; 20: e229-237.
    PubMedGoogle Scholar
  • 50 Choi JC. et al. Survey of the use of warfarin and the newer anticoagulant dabigatran in patients with atrial fibrillation. Patient Prefer Adherence 2014; 8: 167-177.
    PubMedGoogle Scholar
  • 51 Fatima S. et al. Development and validation of a decision aid for choosing among antithrombotic agents for atrial fibrillation. Thromb Res 2016; 145: 143-148.
    CrossrefPubMedGoogle Scholar
  • 52 Man-Son-Hing M. et al. A patient decision aid regarding antithrombotic therapy for stroke prevention in atrial fibrillation. J Am Med Assoc 1999; 282: 737-743.
    CrossrefPubMedGoogle Scholar
  • 53 Elewa HF. et al. Patients satisfaction with warfarin and willingness to switch to dabigatran: a patient survey. J Thromb Thrombolysis 2014; 38: 115-120.
    CrossrefPubMedGoogle Scholar
  • 54 Man-Son-Hing M. et al. The effect of qualitative vs quantitative presentation of probability estimates on patient decision-making: a randomized trial. Health Expect 2002; 5: 246-255.
    CrossrefPubMedGoogle Scholar
  • 55 Holbrook A. et al. Influence of decision aids on patient preferences for anticoagulant therapy: a randomized trial. CMAJ 2007; 176: 1583-1587.
    CrossrefPubMedGoogle Scholar
  • 56 Holbrook A. et al. Personalized benefit-harm information influences patient decisions regarding warfarin. J Popul Ther Clin Pharmacol 2013; 20: e406-415.
    PubMedGoogle Scholar
  • 57 Howitt A, Armstrong D. Implementing evidence based medicine in general practice: audit and qualitative study of antithrombotic treatment for atrial fibrillation. Br Med J 1999; 318: 1324-1327.
    CrossrefPubMedGoogle Scholar
  • 58 Protheroe J. et al. Effects of patients’ preferences on the treatment of atrial fibrillation: observational study of patient-based decision analysis. West J Med 2001; 174: 311-315.
    CrossrefPubMedGoogle Scholar
  • 59 Najafzadeh M. et al. Patients’ preferences in anticoagulant therapy: discrete choice experiment. Circ Cardiovasc Qual Outcomes 2014; 7: 912-919.
    CrossrefPubMedGoogle Scholar
  • 60 Andrade SE. et al. Methods for evaluation of medication adherence and persistence using automated databases. Pharmacoepidem Drug Safety 2006; 15: 565-574.
    PubMedGoogle Scholar
  • 61 Fraenkel L. et al. A pilot randomized controlled trial of a decision support tool to improve the quality of communication and decision-making in individuals with atrial fibrillation. J Am Geriatr Soc 2012; 60: 1434-1441.
    CrossrefPubMedGoogle Scholar
  • 62 Thomson RG. et al. A patient decision aid to support shared decision-making on anti-thrombotic treatment of patients with atrial fibrillation: randomised controlled trial. Qual Saf Health Care 2007; 16: 216-223.
    CrossrefPubMedGoogle Scholar
  • 63 Eckman MH. et al. Developing an Atrial Fibrillation Guideline Support Tool (AFGuST) for shared decision making. Curr Med Res Opin 2015; 31: 603-614.
    CrossrefPubMedGoogle Scholar
  • 64 LaHaye SA. et al. A clinical decision aid for the selection of antithrombotic therapy for the prevention of stroke due to atrial fibrillation. Eur Heart J 2012; 33: 2163-2171.
    CrossrefPubMedGoogle Scholar
  • 65 Prescribing Decision Support, Centre for Medicines Optimisation, editor. Keele Anticoagulation Therapy Decision Support Tool. anticoagulation-dst.co.uk 2016 Available at: http://www.anticoagulation-dst.co.uk/ Accessed December 5, 2016
    PubMed
  • 66 Loewen PS. SPARCtool. sparctool.com. Available at: www.sparctool.com Accessed December 30, 2016
    PubMed
  • 67 Mühlbacher AC. et al. Experimental measurement of preferences in health and healthcare using best-worst scaling: an overview. Health Econ Rev 2015; 6: 1-14.
    PubMedGoogle Scholar
  • 68 Ryan M. Discrete choice experiments in health care. Br Med J 2004; 328: 360-361.
    CrossrefPubMedGoogle Scholar
  • 69 Reed Johnson F. et al. Constructing experimental designs for discrete-choice experiments: report of the ISPOR Conjoint Analysis Experimental Design Good Research Practices Task Force. Value Health 2013; 16: 3-13.
    CrossrefPubMedGoogle Scholar
  • 70 Kovacs RJ. et al. Practical Management of Anticoagulation in Patients With Atrial Fibrillation. JACC 2015; 65: 1340-1360.
    CrossrefPubMedGoogle Scholar
  • 71 Gomes T. et al. Rates of hemorrhage during warfarin therapy for atrial fibrillation. CMAJ 2013; 185: E121-127.
    CrossrefPubMedGoogle Scholar
  • 72 Chai-Adisaksopha C. et al. Mortality outcomes in patients receiving direct oral anticoagulants: a systematic review and meta-analysis of randomized controlled trials. J Thromb Haemost 2015; 13: 2012-2020.
    CrossrefPubMedGoogle Scholar
  • 73 Fang MC. et al. Death and disability from warfarin-associated intracranial and extracranial hemorrhages. Am J Med 2007; 120: 700-705.
    CrossrefPubMedGoogle Scholar
  • 74 Thomson R. et al. Decision analysis and guidelines for anticoagulant therapy to prevent stroke in patients with atrial fibrillation. Lancet 2000; 355: 956-962.
    CrossrefPubMedGoogle Scholar
  • 75 The SPAF III Writing Committee. Patients with nonvalvular atrial fibrillation at low risk of stroke during treatment with aspirin. J Am Med Assoc 1998; 279: 1273-1277.
    CrossrefPubMedGoogle Scholar
  • 76 Giglio AF. et al. Increased risk of myocardial infarction with dabigatran: fact or fiction?. J Cardiovasc Med 2014; 15: 19-26.
    CrossrefPubMedGoogle Scholar