Preferences of Patients, Their Family Caregivers and Vascular Surgeons in the Choice of Abdominal Aortic Aneurysms Treatment Options: The PREFER Study

Abstract Objective Factors influencing the choice between endovascular (endovascular aneurysm repair, EVAR) and open repair (OPEN) of abdominal aortic aneurysm (AAA) are of increasing interest. We quantified their importance among the different subjects involved in the treatment. Methods Pre- and po...

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Bibliographic Details
Published in:	European journal of vascular and endovascular surgery 2011-07, Vol.42 (1), p.26-34
Main Authors:	Faggioli, G, Scalone, L, Mantovani, L.G, Borghetti, F, Stella, A
Format:	Article
Language:	eng
Subjects:	Abdominal aortic aneurysm Activities of Daily Living Aged Aged, 80 and over Anesthesia Aortic Aneurysm, Abdominal - economics Aortic Aneurysm, Abdominal - psychology Aortic Aneurysm, Abdominal - surgery Attitude of Health Personnel Caregivers - psychology Choice Behavior Discrete choice analysis Endovascular Procedures - adverse effects Endovascular Procedures - economics Endovascular Procedures - psychology Female Health Care Costs Health Knowledge, Attitudes, Practice Health Services Research Humans Italy Length of Stay Logistic Models Male Middle Aged Outcome and Process Assessment (Health Care) Patient Preference Postoperative Complications - etiology Postoperative Complications - psychology Preferences Recovery of Function Reoperation Risk Assessment Risk Factors Surgery Surveys and Questionnaires Time Factors Treatment choices Treatment Outcome Vascular Surgical Procedures - adverse effects Vascular Surgical Procedures - economics Vascular Surgical Procedures - psychology
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Summary:	Abstract Objective Factors influencing the choice between endovascular (endovascular aneurysm repair, EVAR) and open repair (OPEN) of abdominal aortic aneurysm (AAA) are of increasing interest. We quantified their importance among the different subjects involved in the treatment. Methods Pre- and postoperative patients (pts), their relatives and vascular surgeons completed questionnaires evaluating six treatment characteristics: anaesthesia; recovery time to basic everyday activities; risk of re-intervention at 5 years (RR); complexity of follow-up; risk of major complications; and additional cost of intervention (AC). Through a discrete choice experiment, hypothetical scenarios of treatment were obtained and the relative importance (RI) of each characteristic was determined through a conditional logistic regression model. Results A total of 160 pts, 102 relatives and 30 surgeons from nine centres completed the questionnaires. Major complications and re-intervention risk were the most important characteristics (RI = 56.0% and 27.2%, respectively) for all the respondent categories. Pts and their relatives considered very important also a possible out-of-pocket AC. Recovery time and type of anaesthesia were among the least important characteristics, including hospital additional cost for surgeons. The different categories of respondents showed different opinions towards different treatment characteristics depending also on possible previous treatment. Conclusion Preferences for AAA treatment characteristics differ between groups of involved subjects. Understanding individuals’ preferences could help in optimising treatment benefits.
ISSN:	1078-5884 1532-2165