TREATMENT AFTER ACUTE CORONARY SYNDROME: ANALYSIS OF PATIENT'S PRIORITIES WITH ANALYTIC HIERARCHY PROCESS

• Published in: International journal of technology assessment in health care Vol. 32; no. 4; p. 284
• Main Authors: Mühlbacher, Axel C, Bethge, Susanne, Kaczynski, Anika
• Format: Journal Article
• Language: English
• Published: England 01-01-2016
• Subjects: Acute Coronary Syndrome - drug therapy; Acute Coronary Syndrome - mortality; Acute Coronary Syndrome - psychology; Adult; Aged; Aged, 80 and over; Body Mass Index; Cardiovascular Agents - administration & dosage; Cardiovascular Agents - adverse effects; Cardiovascular Agents - therapeutic use; Decision Support Techniques; Female; Humans; Male; Middle Aged; Myocardial Infarction - prevention & control; Patient Acceptance of Health Care - psychology; Patient Preference - psychology; Risk Factors; Socioeconomic Factors; Patient priorities; Acute coronary syndrome; Analytic hierarchy process
• ISSN: 1471-6348
• DOI: 10.1017/S0266462316000428

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.
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.
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).
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.