title: Preferences of patients, their family caregivers and vascular surgeons in the choice of abdominal aortic aneurysms treatment options: the PREFER study.
abstract: OBJECTIVE
  Factors influencing the choice between endovascular (endovascular aneurysm repair, EVAR) and open repair (OPEN) of abdominal aortic aneurysm (AAA) are of increasing interest. We quantified their importance among the different subjects involved in the treatment.
  
  
  METHODS
  Pre- and postoperative patients (pts), their relatives and vascular surgeons completed questionnaires evaluating six treatment characteristics: anaesthesia; recovery time to basic everyday activities; risk of re-intervention at 5 years (RR); complexity of follow-up; risk of major complications; and additional cost of intervention (AC). Through a discrete choice experiment, hypothetical scenarios of treatment were obtained and the relative importance (RI) of each characteristic was determined through a conditional logistic regression model.
  
  
  RESULTS
  A total of 160 pts, 102 relatives and 30 surgeons from nine centres completed the questionnaires. Major complications and re-intervention risk were the most important characteristics (RI = 56.0% and 27.2%, respectively) for all the respondent categories. Pts and their relatives considered very important also a possible out-of-pocket AC. Recovery time and type of anaesthesia were among the least important characteristics, including hospital additional cost for surgeons. The different categories of respondents showed different opinions towards different treatment characteristics depending also on possible previous treatment.
  
  
  CONCLUSIONS
  Preferences for AAA treatment characteristics differ between groups of involved subjects. Understanding individuals' preferences could help in optimising treatment benefits.
authors.affiliation: Vascular Surgery, University of Bologna, S.Orsola Malpighi Hospital, Bologna, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Faggioli
authors.forename: L
authors.initials: L
authors.lastname: Scalone
authors.forename: L G
authors.initials: LG
authors.lastname: Mantovani
authors.forename: F
authors.initials: F
authors.lastname: Borghetti
authors.forename: A
authors.initials: A
authors.lastname: Stella
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia; D017544:Aortic Aneurysm, Abdominal / Q000191:economics / Q000523:psychology / Q000601:surgery*; D001291:Attitude of Health Personnel; D017028:Caregivers / Q000523:psychology; D002755:Choice Behavior; D057510:Endovascular Procedures / Q000009:adverse effects / Q000191:economics / Q000523:psychology; D005260:Female; D017048:Health Care Costs; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research; D006801:Humans; D007558:Italy; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D057240:Patient Preference; D011183:Postoperative Complications / Q000209:etiology / Q000523:psychology; D020127:Recovery of Function; D012086:Reoperation; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000191:economics / Q000523:psychology