Patient preferences for management of high blood pressure in the UK: A discrete choice experiment

Benjamin Fletcher, Lisa Hinton, Richard McManus, Oliver Rivero-Arias

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
104 Downloads (Pure)

Abstract

Background 

With a variety of potentially effective hypertension management options, it is important to determine how patients value different models of care, and the relative importance of factors in their decision-making process.

 

Aim 

To explore patient preferences for the management of hypertension in the UK.

Design and setting Online survey of patients who have hypertension in the UK including an unlabelled discrete choice experiment (DCE).

 

Method 

A DCE was developed to assess patient preferences for the management of hypertension based on four attributes: model of care, frequency of blood pressure (BP) measurement, reduction in 5-year cardiovascular risk, and costs to the NHS. A mixed logit model was used to estimate preferences, willingness-to-pay was modelled, and a scenario analysis was conducted to evaluate the impact of changes in attribute levels on the uptake of different models of care.

 

Results 

One hundred and sixty-seven participants completed the DCE (aged 61.4 years, 45.0% female, 82.0% >5 years since diagnosis). All four attributes were significant in choice (P<0.05). Reduction in 5-year cardiovascular risk was the main driver of patient preference as evidenced in the scenario and willingness-to-pay analyses. GP management was significantly preferred over self-management. Patients preferred scenarios with more frequent BP measurement, and lower costs to the NHS.

 

Conclusion 

Participants had similar preferences for GP management, pharmacist management, and telehealth, but a negative preference for self-management. When introducing new models of care for hypertension to patients, discussion of the potential benefits in terms of risk reduction should be prioritised to maximise uptake.

Original languageEnglish
Pages (from-to)e629-e637
Number of pages9
JournalBritish Journal of General Practice
Volume69
Issue number686
Early online date29 Aug 2019
DOIs
Publication statusPublished - Sep 2019

Keywords

  • general practice
  • hypertension
  • patient preference

ASJC Scopus subject areas

  • Family Practice

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