title: TREATMENT AFTER ACUTE CORONARY SYNDROME: ANALYSIS OF PATIENT'S PRIORITIES WITH ANALYTIC HIERARCHY PROCESS.
abstract: BACKGROUND
  Cardiovascular disease is one of the most common causes of death worldwide, with many individuals having experienced acute coronary syndrome (ACS). How patients with a history of ACS value aspects of their medical treatment have been evaluated rarely. The aim of this study was to determine patient priorities for long-term drug therapy after experiencing ACS.
  
  
  METHODS
  To identify patient-relevant treatment characteristics, a systematic literature review and qualitative patient interviews were conducted. A questionnaire was developed to elicit patient's priorities for different characteristics of ACS treatment using Analytic Hierarchy Process (AHP). To evaluate the patient-relevant outcomes, the eigenvector method was applied.
  
  
  RESULTS
  Six-hundred twenty-three patients participated in the computer-assisted personal interviews and were included in the final analysis. Patients showed a clear priority for the attribute "reduction of mortality risk" (weight: 0.402). The second most preferred attribute was the "prevention of a new myocardial infarction" (weight: 0.272), followed by "side effect: dyspnea" (weight: 0.165) and "side effect: bleeding" (weight: 0.117). The "frequency of intake" was the least important attribute (weight: 0.044).
  
  
  CONCLUSIONS
  In conclusion, this study shows that patients strongly value a reduction of the mortality risk in post-ACS treatment. Formal consideration of patient preferences and priorities can help to inform a patient-centered approach, clinical practice, development of future effective therapies, and health policy for decision makers that best represents the needs and goals of the patient.
authors.affiliation: Hochschule Neubrandenburg,Neubrandenburg,GermanyCommonwealth Fund Harkness Fellow,Duke University,Durham,USAmuehlbacher@hs-nb.de.
authors.forename: Axel C
authors.initials: AC
authors.lastname: Mühlbacher
authors.affiliation: Hochschule Neubrandenburg,Neubrandenburg,Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Bethge
authors.affiliation: Hochschule Neubrandenburg,Neubrandenburg,Germany.
authors.forename: Anika
authors.initials: A
authors.lastname: Kaczynski
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000401:mortality / Q000523:psychology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002317:Cardiovascular Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000517:prevention & control; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D057240:Patient Preference / Q000523:psychology*; D012307:Risk Factors; D012959:Socioeconomic Factors
chemical_list: D002317:Cardiovascular Agents
keywords: Acute coronary syndrome; Analytic hierarchy process; Patient priorities