[Preferences for oral anticoagulant treatment in the medium and long term prevention of stroke in non valvular atrial fibrillation].
BACKGROUND
About 40% of patients who receive oral anticoagulation would not start treatment with vitamin K antagonists due to the regular control they require and their interference with the diet and other concomitant medications.


OBJECTIVE
To analyze the preferences of patients with non valvular atrial fibrillation for oral anticoagulants (OAs) for the stroke prevention.


METHODS
Observational, multicentric study on preferences and maximum willingness to pay based on conjoint analysis: literature review, focus groups and semi-structured interviews with physicians and patients (n = 295) to define the attributes of OAs and their levels. Definition of scenarios that patients ordered according to their preferences. Clusters analysis to identify population groups by their preferences.


RESULTS
Eight scenarios were defined based on five attributes: efficacy, security, a fixed dose, need for coagulation controls and interactions with diet and medication. The most preferred attribute was the smaller number of embolisms in a year (importance: 30.15%) followed by the fixed dose of the OA (25.45%) and the smaller number of intracranial hemorrhage in a year (21.57%). Three clusters population were identified. The maximum amount patients' were willingness to pay for the OA was 66.76 ± 54.64 euros (mean) per month.


CONCLUSIONS
Efficacy and a fixed dose are the attributes of OA most valued by non valvular atrial fibrillation patients. There are groups of patients who differ in their preferences. This differences should be taken into account when deciding instauration or change on the OA treatment to ameliorate the accomplishment and prevention in this patients.
Boehringer Ingelheim España S.A.
Nuria
N
González-Rojas
Emmanuel
E
Giménez
M Ángeles
MÁ
Fernández
Ana I
AI
Heineger
José L
JL
Martínez
Julia
J
Villar
Luis
L
Lizán
D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage* / Q000145:classification / Q000191:economics / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications*; D003430:Cross-Sectional Studies; D004347:Drug Interactions; D065427:Factor Xa Inhibitors; D018565:Food-Drug Interactions; D006801:Humans; D055118:Medication Adherence; D008875:Middle Aged; D057240:Patient Preference; D011306:Prescription Fees; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*; D019851:Thrombophilia / Q000188:drug therapy* / Q000209:etiology; D013997:Time Factors; D014812:Vitamin K / Q000037:antagonists & inhibitors
D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D014812:Vitamin K