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Patient Preferences for Hypertension Treatment Outcomes: A Quantitative Field Study Using the Analytic Hierarchy

Stefanie Gröls1, Andrea Icks2,3,4, Georg Wolff5,6

  • 1Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düssseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany. Stefanie.Groels@hhu.de.

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Summary

Patients with hypertension prioritize avoiding stroke and death equally over other outcomes. Incorporating these patient preferences into care can improve treatment adherence and results.

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Area of Science:

  • Cardiology
  • Neurology
  • Public Health

Background:

  • Hypertension is a significant risk factor for cardiovascular and cerebrovascular events.
  • Poor treatment adherence hinders effective hypertension management.
  • Patient preferences are crucial for improving adherence and treatment success.

Purpose of the Study:

  • To identify patient preferences for hypertension treatment outcomes using the analytic hierarchy process (AHP).
  • To explore associations between preferences, prior events, demographics, and health-related quality of life (HRQoL).

Main Methods:

  • Quantitative exploratory field study involving pairwise comparisons of outcomes among hypertensive patients.
  • Calculation of individual outcome weights using the eigenvector method.
  • Assessment of HRQoL using the EQ-5D-5L instrument and visual analogue scale.

Main Results:

  • Stroke and death were equally prioritized as the most concerning outcomes (weights: 0.271 and 0.270, respectively).
  • Myocardial infarction (0.191), acute heart failure (0.176), and adverse drug reactions (ADRs) (0.091) followed.
  • Dyspnea was the most concerning ADR; patients with prior stroke prioritized stroke avoidance, while those with prior myocardial infarction prioritized death avoidance.

Conclusions:

  • This study, the first to use AHP for hypertension treatment preferences, highlights stroke and death as equally prioritized outcomes.
  • Prolonging life is not universally the primary patient goal.
  • Integrating patient preferences can foster patient-centered care, enhancing adherence and outcomes.