Patient preferences for heart valve disease intervention.

Area of Science:

• Cardiovascular Medicine
• Health Economics
• Patient-Reported Outcomes

Background:

• Heart valve disease (HVD) necessitates treatment decisions involving trade-offs between procedure benefits and risks.
• Understanding patient preferences is crucial for optimizing HVD treatment strategies and resource allocation.

Purpose of the Study:

• To determine how patients with HVD weigh the benefits and risks of invasive versus minimally invasive procedures.
• To identify patient preferences for HVD treatments and the relative importance of specific treatment attributes.

Main Methods:

• A discrete choice experiment (DCE) was conducted with 143 Australian and 206 Japanese patients undergoing heart valve procedures.
• DCE attributes included mortality risk, stroke risk, need for dialysis/pacemaker, valve durability, post-surgery independence, and out-of-pocket costs.
• A mixed multinomial logit model analyzed patient choices between hypothetical invasive and minimally invasive procedures.

Main Results:

• Both Australian and Japanese patients showed a preference for minimally invasive procedures over invasive ones.
• Valve durability and likelihood of independence post-procedure were the most significant factors influencing patient choices.
• Patient preferences varied between countries, with Australians prioritizing valve durability and Japanese patients emphasizing regaining independence.

Conclusions:

• Minimally invasive procedures are preferred by HVD patients, regardless of prior treatment experience.
• Valve durability and recovery speed are key attributes driving patient treatment preferences.
• Findings can inform healthcare decision-makers on patient-centered HVD treatment considerations.