Anticoagulation treatment in cancer-Associated venous thromboembolism: Assessment of patient preferences using a discrete choice experiment (cosimo study): Thrombosis and Haemostasis

N. Picker, A.Y. Lee, A.T. Cohen, A. Maraveyas, J. Beyer-Westendorf, L.G. Mantovani, K. Abdelgawwad, S. Fatoba, I.-M. Thate-Waschke, M. Bach, T. Wilke

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction â Clinical guidelines recommend anticoagulation therapy for the treatment of cancer-Associated venous thromboembolism (VTE), but little is known about preferences. Therefore, the objective of this discrete choice experiment (DCE) was to elucidate patient preferences regarding anticoagulation convenience attributes. Methods â Adult patients with cancer-Associated VTE who switched to direct oral anticoagulants were included in a single-Arm study (COSIMO). Patients were asked to decide between hypothetical treatment options based on a combination of the following attributes: route of administration (injection/tablet), frequency of intake (once/twice daily), need for regular controls of the international normalized ratio (INR) at least every 3 to 4 weeks (yes/no), interactions with food/alcohol (yes/no), and distance to treating physician (1 vs. 20 km) as an additional neutral attribute. DCE data were collected by structured telephone interviews and analyzed based on a conditional logit regression. Results â Overall, 163 patients (mean age 63.7 years, 49.1% female) were included. They strongly preferred oral administration compared with self-injections (importance of this attribute for overall treatment decisions: 73.8%), and a treatment without dietary restrictions (11.8%). Even if these attributes were less important (7.2% and 6.5%, respectively), patients indicated a preference for a shorter distance to the treating physician and once-daily dosing compared with twice-daily intake. Need for regular controls of INR at least every 3 to 4 weeks showed no significant impact on the treatment decision (0.7%). Conclusion â This study showed that treatment-related decision making in cancer-Associated VTE, assuming comparable effectiveness and safety of anticoagulant treatments, is predominantly driven by route of administration, with patients strongly preferring oral administration. © 2021 Georg Thieme Verlag. All rights reserved.
Original languageEnglish
Pages (from-to)206-215
Number of pages10
JournalThromb. Haemost.
Volume121
Issue number2
DOIs
Publication statusPublished - 2021

Keywords

  • anticoagulation
  • cancer-Associated venous thromboembolism
  • discrete choice experiment
  • patient preferences
  • treatment-related decision making

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