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Reasons underpinning patients' preferences for various angina treatments

Reasons underpinning patients' preferences for various angina treatments
Reasons underpinning patients' preferences for various angina treatments
Objective To elicit patients' preferences for the treatment of angina.Design Angina patients were interviewed in order to elicit their personal reasons underlying preferences for various treatment options. Interviews followed a general repertory grid technique, in which seven treatment options were presented to patients in triads. Treatments considered ranged from medication to invasive revascularization therapies, with a 'no treatment' option.Setting Two general practices in Norwich, Norfolk.Subjects Twenty-one patients with diagnosed angina, which was both mild and stable.Main outcome measures Treatment preferences verbalized by patients during interview, and the underlying reasons for these.Results Attitudes voiced towards the range of treatments for angina were diverse; 27 different reasons underlying patients' preferences were identified. Patients' preferences were largely justified by reasons associated with the conditional effectiveness or otherwise of treatments. When presented with treatment triads, medication (drug) treatments were over 2.5 times more likely to be chosen as a most preferred option than invasive or surgical treatments. Although surgical treatments were generally considered to be 'effective', it was perceived that they were more appropriate for situations when the condition became life-threatening. There were occasions, however, when preferences were driven by other reasons, such as a desire to avoid surgery because it was perceived negatively as 'invasive' and 'frightening'. Drug treatments were viewed as 'quick', 'easy' and reversible. Personal experiences of the effectiveness or otherwise of treatments were frequently cited as reasons for stated preferences. However, patients often commented that they would prefer the doctor to make the decision about their treatment.Conclusions Patients choices among treatments was largely driven by perceptions of their effectiveness or otherwise. Although surgery was perceived as 'effective' it was also seen as conditionally so, dependent upon severity of the condition - which is not necessarily the case, as the risks of adverse events and surgical complications increase for emergency cases. As such, access to better information about the effectiveness and timeliness of interventions is needed. Although respondents held anxieties about treatment, particularly invasive or surgical treatments, fewer choices were driven by emotional and lifestyle factors unrelated to 'effectiveness', such as fear or ease of treatment.
angina, cardiology, patients' preferences, perceptions, NEED
1369-6513
246 - 256
Lambert, N.
3004fcf7-1a30-4b10-8024-e527eaddf160
Rowe, G.
b93042b5-4245-49b1-ae6e-1461dec86c99
Bowling, A.
796ca209-687f-4079-8a40-572076251936
Ebrahim, S.
cc462d6d-f796-479f-8126-7a48fcb965d4
Laurence, M.
1718fe16-cd1e-4368-a14f-28304baeeb8d
Dalrymple, J.
4173ed56-35be-468d-a18d-115b42dbd26b
Thomson, R.
0a8ef4e9-3fca-495d-8105-7a846e8118d7
Lambert, N.
3004fcf7-1a30-4b10-8024-e527eaddf160
Rowe, G.
b93042b5-4245-49b1-ae6e-1461dec86c99
Bowling, A.
796ca209-687f-4079-8a40-572076251936
Ebrahim, S.
cc462d6d-f796-479f-8126-7a48fcb965d4
Laurence, M.
1718fe16-cd1e-4368-a14f-28304baeeb8d
Dalrymple, J.
4173ed56-35be-468d-a18d-115b42dbd26b
Thomson, R.
0a8ef4e9-3fca-495d-8105-7a846e8118d7

Lambert, N., Rowe, G., Bowling, A., Ebrahim, S., Laurence, M., Dalrymple, J. and Thomson, R. (2004) Reasons underpinning patients' preferences for various angina treatments. Health Expectations, 7 (3), 246 - 256. (doi:10.1111/j.1369-7625.2004.00282.x). (PMID:15327463)

Record type: Article

Abstract

Objective To elicit patients' preferences for the treatment of angina.Design Angina patients were interviewed in order to elicit their personal reasons underlying preferences for various treatment options. Interviews followed a general repertory grid technique, in which seven treatment options were presented to patients in triads. Treatments considered ranged from medication to invasive revascularization therapies, with a 'no treatment' option.Setting Two general practices in Norwich, Norfolk.Subjects Twenty-one patients with diagnosed angina, which was both mild and stable.Main outcome measures Treatment preferences verbalized by patients during interview, and the underlying reasons for these.Results Attitudes voiced towards the range of treatments for angina were diverse; 27 different reasons underlying patients' preferences were identified. Patients' preferences were largely justified by reasons associated with the conditional effectiveness or otherwise of treatments. When presented with treatment triads, medication (drug) treatments were over 2.5 times more likely to be chosen as a most preferred option than invasive or surgical treatments. Although surgical treatments were generally considered to be 'effective', it was perceived that they were more appropriate for situations when the condition became life-threatening. There were occasions, however, when preferences were driven by other reasons, such as a desire to avoid surgery because it was perceived negatively as 'invasive' and 'frightening'. Drug treatments were viewed as 'quick', 'easy' and reversible. Personal experiences of the effectiveness or otherwise of treatments were frequently cited as reasons for stated preferences. However, patients often commented that they would prefer the doctor to make the decision about their treatment.Conclusions Patients choices among treatments was largely driven by perceptions of their effectiveness or otherwise. Although surgery was perceived as 'effective' it was also seen as conditionally so, dependent upon severity of the condition - which is not necessarily the case, as the risks of adverse events and surgical complications increase for emergency cases. As such, access to better information about the effectiveness and timeliness of interventions is needed. Although respondents held anxieties about treatment, particularly invasive or surgical treatments, fewer choices were driven by emotional and lifestyle factors unrelated to 'effectiveness', such as fear or ease of treatment.

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e-pub ahead of print date: 20 August 2004
Published date: September 2004
Keywords: angina, cardiology, patients' preferences, perceptions, NEED
Organisations: Faculty of Health Sciences

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Local EPrints ID: 334638
URI: http://eprints.soton.ac.uk/id/eprint/334638
ISSN: 1369-6513
PURE UUID: b21bb0f5-6ca0-445a-a840-bdafd8ce1ba7

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Date deposited: 28 Mar 2012 13:20
Last modified: 16 Jul 2019 22:09

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Contributors

Author: N. Lambert
Author: G. Rowe
Author: A. Bowling
Author: S. Ebrahim
Author: M. Laurence
Author: J. Dalrymple
Author: R. Thomson

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