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International Journal of Clinical Pharmacy

, Volume 39, Issue 2, pp 468–472 | Cite as

Patient preferences regarding atrial fibrillation stroke prophylaxis in patients at potential risk of atrial fibrillation

  • Nicholas T. Edwards
  • Erica D. Greanya
  • I fan Kuo
  • Peter S. Loewen
  • Celia L. CulleyEmail author
Short Research Report
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Abstract

Background With an increasing number of options for atrial fibrillation (AF) stroke prophylaxis, there are several medication-related factors to consider. This study aimed to gain a better understanding of which preference factors influence patient decisions when selecting AF stroke prophylaxis. Objective To determine the factors that influence patient stroke prophylaxis decisions and preferred therapeutic options. Methods A questionnaire about AF stroke prophylaxis medication options was distributed to participants at risk of AF. Preferences were elicited through ranking and rating medication preference factor statements, then selecting most and least preferred treatment options. Results Reduced stroke risk and lowest risk of an intracranial haemorrhage (ICH) had the highest median preference factor ranking of 2 (IQR, 1–3.5 for stroke reduction; 2–4 for ICH risk). Reducing stroke risk, availability of a lab test to assess drug effect, and availability of an antidote were the preference factors with the highest ratings. Apixaban was the most preferred treatment option (44% blinded to drug name, 37% unblinded) while ‘No treatment’ was the least preferred option (48% blinded, 52% unblinded). Conclusions Reducing stroke risk and limiting ICH risk were the most important medication factors to participants. High inter-participant preference variability suggests the importance of including the patient in decision-making when selecting AF stroke prophylaxis.

Keywords

Anticoagulation Atrial fibrillation Canada Outpatients Patient preference Prevention Shared decision making Stroke 

Notes

Acknowledgements

The authors would like to thank Rebecca Barnes (Island Health Research and Capacity Building) for her assistance with questionnaire administration.

Funding

No financial support was provided for the conduction of this research.

Conflicts of interest

The authors have no conflicts of interest to disclose.

Supplementary material

11096_2017_440_MOESM1_ESM.docx (175 kb)
Supplementary material 1 (DOCX 174 kb)
11096_2017_440_MOESM2_ESM.docx (15 kb)
Supplementary material 2 (DOCX 14 kb)

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Copyright information

© Springer International Publishing 2017

Authors and Affiliations

  • Nicholas T. Edwards
    • 1
  • Erica D. Greanya
    • 1
    • 2
  • I fan Kuo
    • 3
  • Peter S. Loewen
    • 2
  • Celia L. Culley
    • 1
    • 2
    Email author
  1. 1.Department of PharmacyIsland HealthVictoriaCanada
  2. 2.Faculty of Pharmaceutical SciencesThe University of British ColumbiaVancouverCanada
  3. 3.Faculty of PharmacyUniversity of ManitobaWinnipegCanada

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