Eliciting patients' preferences for elastic compression stocking therapy after deep vein thrombosis: potential for improving compliance

Essentials Elastic compression stocking (ECS) therapy is used to prevent post‐thrombotic syndrome (PTS). We aimed to elicit patient preferences regarding ECS therapy after deep vein thrombosis. The most valued attributes were PTS risk reduction and the ability to put on the ECS independently. Hetero...

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Bibliographic Details
Published in:Journal of thrombosis and haemostasis 2016-03, Vol.14 (3), p.510-517
Main Authors: Bouman, A. C., Ten Cate‐Hoek, A. J., Dirksen, C. D., Joore, M. A.
Format: Article
Language:English
Subjects:
Adult
Aged
Choice Behavior
Compliance
compression
Counseling
Female
Health Knowledge, Attitudes, Practice
Humans
Logistic Models
Male
Middle Aged
Netherlands
Patient Compliance
Patient Education as Topic
Patient Preference
patient preferences
Postthrombotic Syndrome - diagnosis
Postthrombotic Syndrome - etiology
Postthrombotic Syndrome - prevention & control
post‐thrombotic syndrome
Risk Assessment
Risk Factors
stockings
Stockings, Compression
Surveys and Questionnaires
Thrombosis
Time Factors
Treatment Outcome
venous thrombosis
Venous Thrombosis - complications
Venous Thrombosis - diagnosis
Venous Thrombosis - psychology
Venous Thrombosis - therapy
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Summary:Essentials Elastic compression stocking (ECS) therapy is used to prevent post‐thrombotic syndrome (PTS). We aimed to elicit patient preferences regarding ECS therapy after deep vein thrombosis. The most valued attributes were PTS risk reduction and the ability to put on the ECS independently. Heterogeneous results with respect to education level stress the importance of proper counselling. Summary Background Elastic compression stocking (ECS) therapy is used for prevention of post‐thrombotic syndrome (PTS) after deep vein thrombosis (DVT). Current evidence on its effectiveness is conflicting. Compliance, a major determinant of the effectiveness of ECS therapy, remained largely ignored in former studies. Objectives To gain insight into preferences regarding ECS therapy in patients after DVT. Patients/methods A discrete choice experiment was conducted 3 months after DVT in patients enrolled in the IDEAL DVT study, a randomized controlled trial comparing 2 years of ECS therapy with individually tailored duration of ECS therapy for the prevention of PTS. Nine unlabeled, forced‐choice sets of two hypothetical types of ECS were presented to each patient. Data were analyzed with multinomial logit models. Results The respondent sample consisted of 81% (300/369) of invited patients. The most important determinants of preference were PTS risk reduction and putting on the ECS. Patients were willing to increase the duration of therapy by 1 year if this increases the PTS risk reduction with 10%. Patients accepted an increase in the risk of PTS of 29% if they were able to put on the ECS themselves. Preferences were heterogeneous with respect to education level. Conclusions Reduction of the risk of PTS and the ability to put on the ECS without help are the most important characteristics of ECS therapy. Physicians should pay considerable attention to patient education regarding PTS. In addition, patients should be supported in their ability to put on and take off the ECS independently. These rather simple interventions could improve compliance.
ISSN:1538-7933
1538-7836
1538-7836
DOI:10.1111/jth.13228