Patient Preference and Adherence (Nov 2020)
Patient Treatment Preferences for Heart Failure Medications: A Mixed Methods Study
Abstract
Katy E Trinkley,1– 4 Michael G Kahn,5 Larry A Allen,2,4 Heather Haugen,6 Miranda E Kroehl,7 Chen-Tan Lin,2,3 Daniel C Malone,8 Daniel D Matlock2,4,9 1Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA; 2Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA; 3Clinical Informatics, University of Colorado Health, Aurora, CO, USA; 4Adult and Child Consortium for Outcomes Research and Delivery Science, Aurora, CO, USA; 5Section of Informatics and Data Science, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA; 6University of Colorado, Colorado Clinical and Translational Sciences Institute (CCTSI), Aurora, CO, USA; 7Charter Communications Corporation, Greenwood Village, CO, USA; 8Department of Pharmacotherapy, University of Utah Skaggs College of Pharmacy, Salt Lake City, UT, USA; 9VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, CO, USACorrespondence: Katy E TrinkleyUniversity of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, 12850 E Montview Blvd., Mail Stop C238, Aurora, CO 80045, USATel +1-303-724-6563Fax +1-303-724-0979Email [email protected]: Consideration of patient preferences for guideline-directed medical therapies (GDMT) for heart failure with reduced ejection fraction (HFrEF) may help improve major gaps in prescribing and adherence. This study aimed to identify the range and relative priority of factors influencing patients’ decisions to take HFrEF medications.Materials and Methods: This was a convergent mixed methods study of patients with HFrEF. Focus groups were conducted to identify a list of factors followed by individuals rating and ranking the influence of each factor on their decision to take a medication. Using thematic analysis, we summarized preferences into categories.Results: Two focus groups with 13 participants reported 22 factors. Of the factors, “keeping you alive” was most commonly ranked in the top three (seven participants), followed by “communication and understanding” (six participants). Factors were summarized into six categories (listed in order of patient-reported influence): 1) demonstrated improvements in quality of life and longevity, 2) decreased risk of hospitalization, 3) opportunity for shared decision-making and trust in provider, 4) absence of adverse events, 5) affordability, and 6) convenience of taking and absence of interference with daily life.Conclusion: Patients prioritize treatment benefits and being informed more than risks, cost and inconvenience of taking HFrEF medications.Keywords: heart failure, treatment preferences, medication preferences, patient preferences
