Understanding preferences of patients with multivessel coronary artery disease towards revascularisation and optimal medical therapy: a protocol for a discrete choice experiment
Introduction The selection of the optimal treatment strategy remains one of the most challenging decisions in the management of coronary artery disease (CAD). Surgical and percutaneous coronary revascularisation are two widely used treatments for managing CAD and can result in improved outcomes comp...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2025-06-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/6/e094587.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850132911245754368 |
|---|---|
| author | Maria-Jose Santana Tolulope Sajobi Matthew James Nishan Sharma Glen Hazlewood Stephen Wilton Michelle Graham Bryan Har Todd Wilson Maria Dalton Nirav Bhagat Doyin Abatan Gary Semeniuk Ayotunde Kayode Sukhwant Parmar Winnie Pearson Aishah Matar Mohamed Mobarak Alhmoudi |
| author_facet | Maria-Jose Santana Tolulope Sajobi Matthew James Nishan Sharma Glen Hazlewood Stephen Wilton Michelle Graham Bryan Har Todd Wilson Maria Dalton Nirav Bhagat Doyin Abatan Gary Semeniuk Ayotunde Kayode Sukhwant Parmar Winnie Pearson Aishah Matar Mohamed Mobarak Alhmoudi |
| author_sort | Maria-Jose Santana |
| collection | DOAJ |
| description | Introduction The selection of the optimal treatment strategy remains one of the most challenging decisions in the management of coronary artery disease (CAD). Surgical and percutaneous coronary revascularisation are two widely used treatments for managing CAD and can result in improved outcomes compared with medications alone. Current practice guidelines recommend revascularisation for multivessel CAD for most patients. However, there remains uncertainty about whether revascularisation or medical therapy is optimal for managing multivessel disease for many patients, especially, in the elderly and those living with multimorbidity. Also, there is limited understanding of patient preferences towards candidate treatment options for multivessel disease. This study aims to quantify and characterise heterogeneity in patient preferences towards treatment options for multivessel CAD.Methods and analysis We have designed and will administer a discrete choice experiment to elicit and quantify preferences of people with multivessel CAD towards revascularisation and optimal medical therapy for managing multivessel CAD. Multinomial logit mixed effects and hierarchical Bayes models will be used to model the association between the participants’ choices and the attributes and their different levels. The relative importance of the attributes will be assessed using the size of coefficients and marginal rate of substitution (MRS), a measure of the willingness to accept a trade-off among different options. Heterogeneity in patient preferences will be evaluated using latent class analysis.Ethics and dissemination Ethical approval for this study was granted by the University of Calgary Conjoint Health Research Ethics Board. Findings from this study will inform the development of clinical decision support tool that integrates patient preferences with clinical risk information to support patient-care provider discussion about optimal treatment for multivessel CAD management. |
| format | Article |
| id | doaj-art-7b6c06f226fc42c19a45901dc5ba7747 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-7b6c06f226fc42c19a45901dc5ba77472025-08-20T02:32:05ZengBMJ Publishing GroupBMJ Open2044-60552025-06-0115610.1136/bmjopen-2024-094587Understanding preferences of patients with multivessel coronary artery disease towards revascularisation and optimal medical therapy: a protocol for a discrete choice experimentMaria-Jose Santana0Tolulope Sajobi1Matthew James2Nishan Sharma3Glen Hazlewood4Stephen Wilton5Michelle Graham6Bryan Har7Todd Wilson8Maria Dalton9Nirav Bhagat10Doyin Abatan11Gary Semeniuk12Ayotunde Kayode13Sukhwant Parmar14Winnie Pearson15Aishah Matar Mohamed Mobarak Alhmoudi16Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, CanadaDepartment of Community Health Sciences, University of Calgary, Calgary, Alberta, CanadaDepartment of Community Health Sciences, University of Calgary, Calgary, Alberta, CanadaDepartment of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, CanadaMcCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, CanadaLibin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, CanadaFaculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, CanadaLibin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, CanadaDepartment of Community Health Sciences, University of Calgary, Calgary, Alberta, CanadaDepartment of Community Health Sciences, University of Calgary, Calgary, Alberta, CanadaDepartment of Community Health Sciences, University of Calgary, Calgary, Alberta, CanadaDepartment of Community Health Sciences, University of Calgary, Calgary, Alberta, CanadaLibin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, CanadaLibin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, CanadaLibin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, CanadaLibin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, CanadaDepartment of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, CanadaIntroduction The selection of the optimal treatment strategy remains one of the most challenging decisions in the management of coronary artery disease (CAD). Surgical and percutaneous coronary revascularisation are two widely used treatments for managing CAD and can result in improved outcomes compared with medications alone. Current practice guidelines recommend revascularisation for multivessel CAD for most patients. However, there remains uncertainty about whether revascularisation or medical therapy is optimal for managing multivessel disease for many patients, especially, in the elderly and those living with multimorbidity. Also, there is limited understanding of patient preferences towards candidate treatment options for multivessel disease. This study aims to quantify and characterise heterogeneity in patient preferences towards treatment options for multivessel CAD.Methods and analysis We have designed and will administer a discrete choice experiment to elicit and quantify preferences of people with multivessel CAD towards revascularisation and optimal medical therapy for managing multivessel CAD. Multinomial logit mixed effects and hierarchical Bayes models will be used to model the association between the participants’ choices and the attributes and their different levels. The relative importance of the attributes will be assessed using the size of coefficients and marginal rate of substitution (MRS), a measure of the willingness to accept a trade-off among different options. Heterogeneity in patient preferences will be evaluated using latent class analysis.Ethics and dissemination Ethical approval for this study was granted by the University of Calgary Conjoint Health Research Ethics Board. Findings from this study will inform the development of clinical decision support tool that integrates patient preferences with clinical risk information to support patient-care provider discussion about optimal treatment for multivessel CAD management.https://bmjopen.bmj.com/content/15/6/e094587.full |
| spellingShingle | Maria-Jose Santana Tolulope Sajobi Matthew James Nishan Sharma Glen Hazlewood Stephen Wilton Michelle Graham Bryan Har Todd Wilson Maria Dalton Nirav Bhagat Doyin Abatan Gary Semeniuk Ayotunde Kayode Sukhwant Parmar Winnie Pearson Aishah Matar Mohamed Mobarak Alhmoudi Understanding preferences of patients with multivessel coronary artery disease towards revascularisation and optimal medical therapy: a protocol for a discrete choice experiment BMJ Open |
| title | Understanding preferences of patients with multivessel coronary artery disease towards revascularisation and optimal medical therapy: a protocol for a discrete choice experiment |
| title_full | Understanding preferences of patients with multivessel coronary artery disease towards revascularisation and optimal medical therapy: a protocol for a discrete choice experiment |
| title_fullStr | Understanding preferences of patients with multivessel coronary artery disease towards revascularisation and optimal medical therapy: a protocol for a discrete choice experiment |
| title_full_unstemmed | Understanding preferences of patients with multivessel coronary artery disease towards revascularisation and optimal medical therapy: a protocol for a discrete choice experiment |
| title_short | Understanding preferences of patients with multivessel coronary artery disease towards revascularisation and optimal medical therapy: a protocol for a discrete choice experiment |
| title_sort | understanding preferences of patients with multivessel coronary artery disease towards revascularisation and optimal medical therapy a protocol for a discrete choice experiment |
| url | https://bmjopen.bmj.com/content/15/6/e094587.full |
| work_keys_str_mv | AT mariajosesantana understandingpreferencesofpatientswithmultivesselcoronaryarterydiseasetowardsrevascularisationandoptimalmedicaltherapyaprotocolforadiscretechoiceexperiment AT tolulopesajobi understandingpreferencesofpatientswithmultivesselcoronaryarterydiseasetowardsrevascularisationandoptimalmedicaltherapyaprotocolforadiscretechoiceexperiment AT matthewjames understandingpreferencesofpatientswithmultivesselcoronaryarterydiseasetowardsrevascularisationandoptimalmedicaltherapyaprotocolforadiscretechoiceexperiment AT nishansharma understandingpreferencesofpatientswithmultivesselcoronaryarterydiseasetowardsrevascularisationandoptimalmedicaltherapyaprotocolforadiscretechoiceexperiment AT glenhazlewood understandingpreferencesofpatientswithmultivesselcoronaryarterydiseasetowardsrevascularisationandoptimalmedicaltherapyaprotocolforadiscretechoiceexperiment AT stephenwilton understandingpreferencesofpatientswithmultivesselcoronaryarterydiseasetowardsrevascularisationandoptimalmedicaltherapyaprotocolforadiscretechoiceexperiment AT michellegraham understandingpreferencesofpatientswithmultivesselcoronaryarterydiseasetowardsrevascularisationandoptimalmedicaltherapyaprotocolforadiscretechoiceexperiment AT bryanhar understandingpreferencesofpatientswithmultivesselcoronaryarterydiseasetowardsrevascularisationandoptimalmedicaltherapyaprotocolforadiscretechoiceexperiment AT toddwilson understandingpreferencesofpatientswithmultivesselcoronaryarterydiseasetowardsrevascularisationandoptimalmedicaltherapyaprotocolforadiscretechoiceexperiment AT mariadalton understandingpreferencesofpatientswithmultivesselcoronaryarterydiseasetowardsrevascularisationandoptimalmedicaltherapyaprotocolforadiscretechoiceexperiment AT niravbhagat understandingpreferencesofpatientswithmultivesselcoronaryarterydiseasetowardsrevascularisationandoptimalmedicaltherapyaprotocolforadiscretechoiceexperiment AT doyinabatan understandingpreferencesofpatientswithmultivesselcoronaryarterydiseasetowardsrevascularisationandoptimalmedicaltherapyaprotocolforadiscretechoiceexperiment AT garysemeniuk understandingpreferencesofpatientswithmultivesselcoronaryarterydiseasetowardsrevascularisationandoptimalmedicaltherapyaprotocolforadiscretechoiceexperiment AT ayotundekayode understandingpreferencesofpatientswithmultivesselcoronaryarterydiseasetowardsrevascularisationandoptimalmedicaltherapyaprotocolforadiscretechoiceexperiment AT sukhwantparmar understandingpreferencesofpatientswithmultivesselcoronaryarterydiseasetowardsrevascularisationandoptimalmedicaltherapyaprotocolforadiscretechoiceexperiment AT winniepearson understandingpreferencesofpatientswithmultivesselcoronaryarterydiseasetowardsrevascularisationandoptimalmedicaltherapyaprotocolforadiscretechoiceexperiment AT aishahmatarmohamedmobarakalhmoudi understandingpreferencesofpatientswithmultivesselcoronaryarterydiseasetowardsrevascularisationandoptimalmedicaltherapyaprotocolforadiscretechoiceexperiment |