LAUSR

The aim of this study was to examine atrial fibrillation (AF) patients' preferences regarding oral anticoagulation (OAC) characteristics and to investigate differences across five different countries. A multi-center discrete choice experiment (DCE) was conducted in Germany, Sweden, Switzerland, Spain, and Taiwan. Study sites enrolled patients with non-valvular AF who received continuous OAC therapy. The DCE design considered four attributes with two attribute levels each: need for bridging (yes/no), interactions with food/alcohol (yes/no), need for regular international normalized ratio (INR) assessments, and frequency of intake (once/twice daily). Generally, patients (n = 1,391) preferred treatment alternatives which were characterized by "no need of bridging", "no need for regular INR controls", "no interactions with food/alcohol", and "once daily intake". For this desired treatment regimen, patients were willing to accept a substantially higher travel distance/time. German AF patients were strongly impacted in their hypothetical treatment decision by the frequency of intake (37.5%). Swedish patients on the other hand gave little importance to intake frequency (12.6%). In Switzerland, patients were especially concerned with food/alcohol interactions of the medication (34.7%), while this was the least important attribute for Taiwanese patients (18.9%), who ascribed the most homogenous importance to the different treatment attributes overall. In Spain, the need for regular INR assessments especially impacted the patient's treatment decision (31.9%). Patients of all countries attributed a moderate importance to the need for bridging (25.9-34.2%). These findings may facilitate country-specific consideration of patients' preferences regarding OAC therapy, potentially increasing treatment acceptance on the patient's side with the ultimate goal of improving treatment adherence and persistence.