title: Eliciting patients' preferences for elastic compression stocking therapy after deep vein thrombosis: potential for improving compliance.
abstract: ESSENTIALS: Elastic compression stocking (ECS) therapy is used to prevent post-thrombotic syndrome (PTS). We aimed to elicit patient preferences regarding ECS therapy after deep vein thrombosis. The most valued attributes were PTS risk reduction and the ability to put on the ECS independently. Heterogeneous results with respect to education level stress the importance of proper counselling.
  
  
  CONCLUSIONS
  
  
  
  BACKGROUND
  Elastic compression stocking (ECS) therapy is used for prevention of post-thrombotic syndrome (PTS) after deep vein thrombosis (DVT). Current evidence on its effectiveness is conflicting. Compliance, a major determinant of the effectiveness of ECS therapy, remained largely ignored in former studies.
  
  
  OBJECTIVE
  To gain insight into preferences regarding ECS therapy in patients after DVT.
  
  
  METHODS
  A discrete choice experiment was conducted 3 months after DVT in patients enrolled in the IDEAL DVT study, a randomized controlled trial comparing 2 years of ECS therapy with individually tailored duration of ECS therapy for the prevention of PTS. Nine unlabeled, forced-choice sets of two hypothetical types of ECS were presented to each patient. Data were analyzed with multinomial logit models.
  
  
  RESULTS
  The respondent sample consisted of 81% (300/369) of invited patients. The most important determinants of preference were PTS risk reduction and putting on the ECS. Patients were willing to increase the duration of therapy by 1 year if this increases the PTS risk reduction with 10%. Patients accepted an increase in the risk of PTS of 29% if they were able to put on the ECS themselves. Preferences were heterogeneous with respect to education level.
  
  
  CONCLUSIONS
  Reduction of the risk of PTS and the ability to put on the ECS without help are the most important characteristics of ECS therapy. Physicians should pay considerable attention to patient education regarding PTS. In addition, patients should be supported in their ability to put on and take off the ECS independently. These rather simple interventions could improve compliance.
authors.affiliation: Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre, Maastricht, the Netherlands.|Laboratory for Thrombosis and Hemostasis, Maastricht University Medical Centre, Maastricht, the Netherlands.
authors.forename: A C
authors.initials: AC
authors.lastname: Bouman
authors.affiliation: Laboratory for Thrombosis and Hemostasis, Maastricht University Medical Centre, Maastricht, the Netherlands.
authors.forename: A J
authors.initials: AJ
authors.lastname: Ten Cate-Hoek
authors.affiliation: Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre, Maastricht, the Netherlands.
authors.forename: C D
authors.initials: CD
authors.lastname: Dirksen
authors.affiliation: Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre, Maastricht, the Netherlands.
authors.forename: M A
authors.initials: MA
authors.lastname: Joore
mesh_terms: D000328:Adult; D000368:Aged; D002755:Choice Behavior; D003376:Counseling; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010349:Patient Compliance; D010353:Patient Education as Topic; D057240:Patient Preference; D054070:Postthrombotic Syndrome / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D018570:Risk Assessment; D012307:Risk Factors; D053828:Stockings, Compression; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000150:complications / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*
keywords: compression; patient compliance; patient preferences; post-thrombotic syndrome; stockings; venous thrombosis