TREATMENT AFTER ACUTE CORONARY SYNDROME: ANALYSIS OF PATIENT'S PRIORITIES WITH ANALYTIC HIERARCHY PROCESS
Axel C Mühlbacher1, Susanne Bethge2, Anika Kaczynski2
1Hochschule Neubrandenburg,Neubrandenburg,GermanyCommonwealth Fund Harkness Fellow,Duke University,Durham,USAmuehlbacher@hs-nb.de.
Insights
Patients after acute coronary syndrome (ACS) prioritize reducing mortality risk and preventing new heart attacks above other treatment factors. Understanding these patient priorities is crucial for developing effective, patient-centered cardiovascular therapies.
Area of Science:
- Cardiology
- Health Services Research
- Patient-Reported Outcomes
Background:
- Cardiovascular disease remains a leading global cause of death.
- Acute coronary syndrome (ACS) affects many individuals worldwide.
- Patient priorities for long-term drug therapy post-ACS are under-researched.
Purpose of the Study:
- To determine patient priorities for long-term drug therapy following ACS.
- To identify key treatment characteristics valued by patients with a history of ACS.
Main Methods:
- Systematic literature review and qualitative patient interviews.
- Development of a questionnaire using Analytic Hierarchy Process (AHP) to elicit priorities.
- Application of the eigenvector method for outcome evaluation.
Main Results:
- 623 patients participated in computer-assisted personal interviews.
- Highest priority: reduction of mortality risk (weight: 0.402).
- Second priority: prevention of myocardial infarction (weight: 0.272).
- Side effects (dyspnea, bleeding) and frequency of intake were lower priorities.
Conclusions:
- Patients with ACS history strongly prioritize mortality risk reduction in treatment.
- Incorporating patient preferences enhances patient-centered care, clinical practice, and health policy.
- Understanding patient priorities informs the development of future effective cardiovascular therapies.
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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