Do Treatment Preferences for Patients with Angina Change? An 18-month Follow-up Study

Objectives: To assess whether preferences for patients with angina changed at 18-month follow-up using the Patient Preferences Questionnaire for Angina treatment (PPQA).

Background: Evidence suggests that patients want information about treatment options. Reliable measurement of patient preferences for treatment is important for empowering patients.

Design: Postal self-administered questionnaire survey at baseline and follow-up. The preference questionnaire comprised 18 items about the main treatments for angina: medication, angioplasty and coronary artery bypass grafting (CABG).

Setting And Participants: Patients with diagnosed angina from seven participating general practices across England. The sample comprised 222 patients with angina who responded to both baseline and follow-up treatment preference questionnaires.

Results: Most patients' condition and preferences scores for treatment remained stable over 18 months. An exception was angioplasty preference scores, which indicated more negative attitudes towards this procedure over time. People aged over 75 years least preferred angioplasty. There were no associations between any changes in condition and changes in preferences. However, within-subject agreement could vary by ± 5 to 7 points between baseline and follow-up, with stability apparently worst for the medication and best for surgery sub-scales, raising the question of what represents reasonable stability.

Conclusion: These results suggest preferences are relatively stable, even where there are changes in health, and provide further evidence of the utility (in particular, reliability) of the PPQA. However, this stability in scores did mask some movement in scale scores and in patients' first-ranked treatment choices, showing changing preferences largely from angioplasty to CABG and vice versa, indicating the complexity of preferences.