Abstract
Objectives: Women's preferences for treatment of heavy menstrual bleeding (HMB) are important in clinical decision-making. Our aim was to investigate whether women with HMB have a preference for treatment characteristics of the levonorgestrel intrauterine system (LNG-IUS) or endometrial ablation and to assess the relative importance of these characteristics.
Study Design: A discrete choice experiment was performed in general practices and gynaecology outpatient clinics in the Netherlands. Women with HMB were asked to choose between hypothetical profiles containing characteristics of LNG-IUS or endometrial ablation. Characteristics included procedure performed by gynaecologist or general practitioner; reversibility of the procedure; probability of dysmenorrhea; probability of irregular bleeding; additional use of contraception; need to repeat the procedure after five years; and treatment containing hormones. Data were analysed using panel mixed logit models. The main outcome measures were the relative importance of the characteristics and willingness to make trade-offs.
Results: 165 women completed the questionnaire; 36 (22%) patients were recruited from general practices and 129 (78%) patients were recruited from gynaecology outpatient clinics. The characteristic found most important was whether a treatment contains hormones. Women preferred a treatment without hormones, a treatment with the least side effects, and no need for a repeat procedure or additional contraception. Women completing the questionnaire at the gynaecology outpatient clinic differed from women in primary care in their preference for a definitive treatment to be performed by a gynaecologist.
Conclusions: Whether or not a treatment contains hormones was the most important characteristic influencing patient treatment choice for HMB. Participants preferred characteristics that were mostly related to endometrial ablation, but were willing to trade-off between characteristics. (C) 2018 Elsevier B.V. All rights reserved.
Original language | English |
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Pages (from-to) | 143-147 |
Number of pages | 5 |
Journal | European Journal of Obstetrics & Gynecology and Reproductive Biology |
Volume | 228 |
DOIs | |
Publication status | Published - Sept 2018 |
Keywords
- Discrete choice experiment
- Endometrial ablation
- Heavy menstrual bleeding
- Levonorgestrel intrauterine system
- Patient preference
- RANDOMIZED-CONTROLLED-TRIAL
- 5-YEAR FOLLOW-UP
- CONJOINT-ANALYSIS APPLICATIONS
- BALLOON ABLATION
- MENORRHAGIA
- HEALTH
- HYSTERECTOMY
- OUTCOMES
- MANAGEMENT
- NOVASURE