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Evaluating patient values and preferences for thromboprophylaxis decision making during pregnancy: a study protocol
Pablo Alonso-Coello1, Shanil Ebrahim, Gordon H Guyatt
1Iberoamerican Cochrane Centre, CIBERESP-IIB Sant Pau, Barcelona, 08041, Spain.
BMC Pregnancy and Childbirth
|June 1, 2012
Summary
Pregnant women at risk of venous thromboembolism (VTE) have unknown preferences regarding low molecular weight heparin (LMWH) prophylaxis. This study quantifies their values to inform treatment guidelines and clinical decisions for preventing pregnancy-related VTE.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Health Economics
Background:
- Pregnant women with a history of venous thromboembolism (VTE) face recurrent risks.
- Low molecular weight heparin (LMWH) reduces VTE but presents challenges like inconvenience and cost.
- Patient preferences for LMWH prophylaxis during pregnancy are unknown, creating a knowledge gap.
Purpose of the Study:
- To explore and quantify the preferences of pregnant women regarding LMWH prophylaxis for VTE prevention.
- To understand women's willingness to accept LMWH based on risk reduction and treatment burden.
- To inform clinical guidelines and decision-making for VTE management in pregnancy.
Main Methods:
- Multi-center cross-sectional interview study with 100 women (18-45 years) with prior VTE history.
- Utilized direct choice exercises, visual analog scales, and probability trade-off exercises to elicit preferences.
- Assessed willingness to receive LMWH prophylaxis, determinants of choice, and utilities for health states.
Main Results:
- The study determined the minimum VTE risk reduction threshold at which women would accept LMWH prophylaxis.
- Quantified women's utilities for LMWH prophylaxis burden and VTE-related health states (DVT, PE, hemorrhage).
- Explored factors influencing prophylaxis acceptance, such as education and prior VTE characteristics.
Conclusions:
- Women's preferences for antithrombotic therapy in pregnancy are currently unexplored.
- This research provides quantitative data on women's valuations of VTE risks and LMWH prevention.
- Findings are essential for developing evidence-based guidelines and personalized clinical recommendations.
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