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Tomee SM, Gebhardt WA, de Vries JP, et al. Patients' perceptions of conservative treatment for a small abdominal aortic aneurysm. Patient Prefer Adherence. 2018;12:119-128doi: 10.2147/PPA.S149822.
Tomee, S. M., Gebhardt, W. A., de Vries, J. P., Hamelinck, V. C., Hamming, J. F., & Lindeman, J. H. (2018). Patients' perceptions of conservative treatment for a small abdominal aortic aneurysm. Patient preference and adherence, 12119-128. https://doi.org/10.2147/PPA.S149822
Tomee, Stephanie M, et al. "Patients' perceptions of conservative treatment for a small abdominal aortic aneurysm." Patient preference and adherence vol. 12 (2018): 119-128. doi: https://doi.org/10.2147/PPA.S149822
Tomee SM, Gebhardt WA, de Vries JP, Hamelinck VC, Hamming JF, Lindeman JH. Patients' perceptions of conservative treatment for a small abdominal aortic aneurysm. Patient Prefer Adherence. 2018 Jan 15;12:119-128. doi: 10.2147/PPA.S149822. eCollection 2018. PMID: 29398907; PMCID: PMC5774745.
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Patient Prefer Adherence. 2018 Jan 15;12:119-128. doi: 10.2147/PPA.S149822. eCollection 2018.

Patients' perceptions of conservative treatment for a small abdominal aortic aneurysm.

Patient preference and adherence

Stephanie M Tomee, Winifred A Gebhardt, Jean-Paul Pm de Vries, Victoria C Hamelinck, Jaap F Hamming, Jan Hn Lindeman

Affiliations

  1. Department of Surgery, Leiden University Medical Center, Leiden.
  2. Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden.
  3. Department of Vascular Surgery, St Antonius Hospital, Nieuwegein, Leiden, the Netherlands.

PMID: 29398907 PMCID: PMC5774745 DOI: 10.2147/PPA.S149822

Abstract

BACKGROUND: An abdominal aortic aneurysm (AAA) is a progressive, generally symptomless disease that could ultimately result in a fatal rupture. Current guidelines advise conservative follow-up, and preventive surgical repair once the risk of rupture outweighs the cost of repair (55 mm in men). In developed countries, the majority of patients are diagnosed with AAAs less than 55 mm, and so enter a period of conservative surveillance. An important question is how patients perceive and cope with risk of rupture, AAA diagnosis and treatment, and presented AAA information. The goal of this study was to gain insight into patients' perceptions of conservative treatment for a small AAA to increase patient satisfaction.

METHODS: We conducted semistructured in-depth interviews and used questionnaires measuring health-related quality of life (RAND 36-Item Health Survey 1.0), illness-perceptions (Illness Perception Questionnaire - Revised), and anxiety and depression (Hospital Anxiety and Depression Scale). Interviews were audio recorded and transcript contents were analyzed based on grounded theory. Mean scores of the questionnaires were compared to (population) reference groups.

RESULTS: This study included ten male patients under surveillance for a small AAA from two hospitals in the Netherlands. Patients expressed no fear for AAA rupture, and also reported low levels of anxiety and depression in both the interviews and the Hospital Anxiety and Depression Scale. The presence of an AAA did not affect their social life or emotional well-being. The reported poorer physical health on RAND 36-Item Health Survey 1.0 presumably reflected common presence of comorbidities. Participants stated to that they were content with the frequency and setup of AAA surveillance. However, they generally lacked knowledge about AAA disease and/or treatment options.

CONCLUSION: Conservative AAA follow-up ensures patients that the risks of AAA disease are limited. The vascular surgeon is the most important source of AAA information to patients, and patients fully rely on their vascular surgeon to take control in AAA treatment.

Keywords: abdominal aortic aneurysm; interviews; patient perceptions; patient preference; patient-reported outcome measures; quality of life

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

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