Japanese Patients’ and Physicians’ Preferences for Anticoagulant Use in Atrial Fibrillation: Results from a Discrete-choice Experiment
**Background:** Anticoagulants are recommended for stroke prevention in patients with atrial fibrillation (AF), but are associated with an increased risk of bleeding; therefore, physicians face benefit-risk tradeoffs when prescribing anticoagulants to AF patients. Although the unmet medical need for...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Columbia Data Analytics, LLC
2015-06-01
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| Series: | Journal of Health Economics and Outcomes Research |
| Online Access: | https://doi.org/10.36469/9904 |
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| author | Ken Okumura Hiroshi Inoue Masahiro Yasaka Juan Marcos Gonzalez A. Brett Hauber Bennett Levitan Zhong Yuan Jean Baptiste Briere |
| author_facet | Ken Okumura Hiroshi Inoue Masahiro Yasaka Juan Marcos Gonzalez A. Brett Hauber Bennett Levitan Zhong Yuan Jean Baptiste Briere |
| author_sort | Ken Okumura |
| collection | DOAJ |
| description | **Background:** Anticoagulants are recommended for stroke prevention in patients with atrial fibrillation (AF), but are associated with an increased risk of bleeding; therefore, physicians face benefit-risk tradeoffs when prescribing anticoagulants to AF patients. Although the unmet medical need for safer anticoagulants has been well-documented, there is limited information about the importance that patients and physicians place on cardiovascular events.
**Objectives:** The aim of this study was to quantify patients’ and physicians’ willingness to accept tradeoffs between the benefits and risks of anticoagulants in order to 1) document the potential differences between patients’ and physicians’ perceptions of benefits and risks and 2) support physicians’ clinical decision making.
**Methods:** Preferences from Japanese AF patients and board-eligible or board-certified physicians were elicited using a discrete-choice experiment. Random-parameters logit models were used to estimate importance weights for treatment-related changes in the annual risk of stroke, myocardial infarction, embolism, and bleeding.
**Results:** Japanese patients (N=152) and physicians (N=164) showed different preferences. In particular, among non-fatal outcomes, patients considered disabling stroke to be 16 times more important than non-major clinically relevant bleeding and 2.6 times more important than extra-cranial major bleeding. In contrast, physicians considered the same stroke risk to be 2.7 times more important than non-major clinically relevant bleeding and equally important as major bleeding.
**Conclusions:** Results suggest that Japanese patients are willing to tolerate a greater risk of bleeding in exchange for stroke prevention than are Japanese physicians. The findings demonstrate the importance of physician-patient communication in treatment decisions involving stroke preventative therapies. |
| format | Article |
| id | doaj-art-1a7dff498d2342aca8b03225fec1ab23 |
| institution | Kabale University |
| issn | 2327-2236 |
| language | English |
| publishDate | 2015-06-01 |
| publisher | Columbia Data Analytics, LLC |
| record_format | Article |
| series | Journal of Health Economics and Outcomes Research |
| spelling | doaj-art-1a7dff498d2342aca8b03225fec1ab232025-02-10T16:12:25ZengColumbia Data Analytics, LLCJournal of Health Economics and Outcomes Research2327-22362015-06-0122Japanese Patients’ and Physicians’ Preferences for Anticoagulant Use in Atrial Fibrillation: Results from a Discrete-choice ExperimentKen OkumuraHiroshi InoueMasahiro YasakaJuan Marcos GonzalezA. Brett HauberBennett LevitanZhong YuanJean Baptiste Briere**Background:** Anticoagulants are recommended for stroke prevention in patients with atrial fibrillation (AF), but are associated with an increased risk of bleeding; therefore, physicians face benefit-risk tradeoffs when prescribing anticoagulants to AF patients. Although the unmet medical need for safer anticoagulants has been well-documented, there is limited information about the importance that patients and physicians place on cardiovascular events. **Objectives:** The aim of this study was to quantify patients’ and physicians’ willingness to accept tradeoffs between the benefits and risks of anticoagulants in order to 1) document the potential differences between patients’ and physicians’ perceptions of benefits and risks and 2) support physicians’ clinical decision making. **Methods:** Preferences from Japanese AF patients and board-eligible or board-certified physicians were elicited using a discrete-choice experiment. Random-parameters logit models were used to estimate importance weights for treatment-related changes in the annual risk of stroke, myocardial infarction, embolism, and bleeding. **Results:** Japanese patients (N=152) and physicians (N=164) showed different preferences. In particular, among non-fatal outcomes, patients considered disabling stroke to be 16 times more important than non-major clinically relevant bleeding and 2.6 times more important than extra-cranial major bleeding. In contrast, physicians considered the same stroke risk to be 2.7 times more important than non-major clinically relevant bleeding and equally important as major bleeding. **Conclusions:** Results suggest that Japanese patients are willing to tolerate a greater risk of bleeding in exchange for stroke prevention than are Japanese physicians. The findings demonstrate the importance of physician-patient communication in treatment decisions involving stroke preventative therapies.https://doi.org/10.36469/9904 |
| spellingShingle | Ken Okumura Hiroshi Inoue Masahiro Yasaka Juan Marcos Gonzalez A. Brett Hauber Bennett Levitan Zhong Yuan Jean Baptiste Briere Japanese Patients’ and Physicians’ Preferences for Anticoagulant Use in Atrial Fibrillation: Results from a Discrete-choice Experiment Journal of Health Economics and Outcomes Research |
| title | Japanese Patients’ and Physicians’ Preferences for Anticoagulant Use in Atrial Fibrillation: Results from a Discrete-choice Experiment |
| title_full | Japanese Patients’ and Physicians’ Preferences for Anticoagulant Use in Atrial Fibrillation: Results from a Discrete-choice Experiment |
| title_fullStr | Japanese Patients’ and Physicians’ Preferences for Anticoagulant Use in Atrial Fibrillation: Results from a Discrete-choice Experiment |
| title_full_unstemmed | Japanese Patients’ and Physicians’ Preferences for Anticoagulant Use in Atrial Fibrillation: Results from a Discrete-choice Experiment |
| title_short | Japanese Patients’ and Physicians’ Preferences for Anticoagulant Use in Atrial Fibrillation: Results from a Discrete-choice Experiment |
| title_sort | japanese patients and physicians preferences for anticoagulant use in atrial fibrillation results from a discrete choice experiment |
| url | https://doi.org/10.36469/9904 |
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