Physician and Patient Preferences for Oral Anticoagulation Therapy Decision Making in Atrial Fibrillation: Results From a National Best–Worst Scaling Survey in Türkiye

IF 2.4 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Clinical Cardiology Pub Date : 2024-12-09 DOI:10.1002/clc.70038
K. Kılıckesmez, D. Aras, M. Degertekin, N. Ozer, B. Hacibedel, K. Helvacioglu, U. Koc, B. Ozdengulsun, E. Dundar Ahi, O. Ergene
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Abstract

Atrial fibrillation (AF) is the most common cardiac dysrhythmia and a common cause of ischemic stroke. Stroke prevention with oral anticoagulation (OAC) is the cornerstone of AF management. Patients and their treating physicians may have different views on different attributes of OACs. The objective of this study was to quantify the relative importance that patients and physicians in Turkey place on different OAC attributes when making treatment decisions in AF. A cross-sectional survey was administered to AF patients (≥ 50 years) receiving OAC and practising cardiologists, including residents with ≥ 2 years of experience in Turkey. For both patients (N = 230; 50% male) and physicians (N = 194; 74% male), the most important attributes for OAC treatment decision making in AF were “success in preventing stroke” (57% and 73.9% or overall importance, respectively) and “risk of major bleeding” (20% and 23.4%, respectively). For patients, other attributes were much less important, but not altogether unimportant: reversal agent availability (7%), monitoring (5%), food or drug interactions (3%), minor bleeding (3%), and ease of swallowing (2%). For physicians, among the other attributes, only the need for monitoring (1.3%) had a relative importance of > 1%. For all Turkish participants, efficacy and safety were found to be the most important attributes influencing OAC choice in AF with these two attributes accounting for 77% and 97.3% of overall importance for patients and physicians, respectively. Certain considerations, especially reversal agent availability and monitoring appear to be more important to patients than to physicians This is the first study to use BWS to quantify patient and physician preferences for OAC treatments in AF in Turkey.

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医生和患者对房颤口服抗凝治疗决策的偏好:来自 rkiye全国最佳最差评分调查的结果。
心房颤动(AF)是最常见的心律失常和缺血性中风的常见原因。口服抗凝剂预防脑卒中(OAC)是房颤管理的基石。患者及其主治医生可能对OACs的不同属性有不同的看法。本研究的目的是量化土耳其患者和医生在制定房颤治疗决策时对不同OAC属性的相对重要性。对接受OAC治疗的房颤患者(≥50岁)和执业心脏病专家(包括在土耳其有≥2年经验的住院医师)进行横断面调查。两例患者(N = 230;50%男性)和医生(N = 194;(74%男性),房颤OAC治疗决策的最重要属性是“成功预防卒中”(分别为57%和73.9%或总体重要性)和“大出血风险”(分别为20%和23.4%)。对于患者来说,其他属性不那么重要,但并非完全不重要:逆转药物的可用性(7%)、监测(5%)、食物或药物相互作用(3%)、轻微出血(3%)和吞咽容易(2%)。对于医生来说,在其他属性中,只有需要监测(1.3%)的相对重要性为bb0.1 %。对于所有土耳其参与者,疗效和安全性被发现是影响房颤OAC选择的最重要属性,这两个属性分别占患者和医生总体重要性的77%和97.3%。某些考虑因素,特别是逆转药物的可用性和监测似乎对患者比医生更重要。这是土耳其首次使用BWS来量化AF患者和医生对OAC治疗的偏好。
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来源期刊
Clinical Cardiology
Clinical Cardiology 医学-心血管系统
CiteScore
5.10
自引率
3.70%
发文量
189
审稿时长
4-8 weeks
期刊介绍: Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.
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