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

Published online by Cambridge University Press:  18 October 2016

Axel C. Mühlbacher
Affiliation:
Hochschule Neubrandenburg, Neubrandenburg, GermanyCommonwealth Fund Harkness Fellow, Duke University, Durham, [email protected]
Susanne Bethge
Affiliation:
Hochschule Neubrandenburg, Neubrandenburg, Germany
Anika Kaczynski
Affiliation:
Hochschule Neubrandenburg, Neubrandenburg, Germany

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).

Conclusion: 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.

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Copyright © Cambridge University Press 2016 

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