A Systematic Review Comparing Studies of Cardiovascular Event Utilities by Geographic Region

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measured with EQ-5D-3L in this status was far lower than other utilities assessed with VAS, TTO and EQ-5D-5L due to the ceiling effect of EQ-5D-3L. The utilities of each health status related to HF differed between EQ-5D-3L and EQ-5D-5L significantly, except for SCHF+cough and SCHF+hypotention (p< 0.05). Moreover, the utilities for 5 health statuses varied among VAS, TTO and EQ-5D-5L with statistical significance (p< 0.001).  Conclusions: Although the utilities for HF differed with statistical significance depending on the instrument used, this study has shown the tendency of decreasing utilities with worsening health status due to adverse events and hospitalization in VAS, TTO and EQ-5D. PCV39 A Systematic Review of Cardiovascular Event Utilities in Asia Blieden M1, Szatkowski A1, Cheng L2, Gandra SR3 1Evidera, Lexington, MA, USA, 2Amgen, Inc., Thousand Oaks, CA, USA, 3Amgen Inc., Thousand Oaks, CA, USA

Objectives: This systematic literature review (SLR) aimed to identify and evaluate utilities reported for stroke, acute coronary syndrome (ACS), and heart failure in Asia.  Methods: A SLR was conducted to identify English-language articles in Embase, PubMed, and the grey literature published between 1992 and August 2015 using keywords for cardiovascular (CV) events and utilities. Primary studies reporting utilities for stroke, ACS (including myocardial infarction and angina), and heart failure in adults were included. Utilities were evaluated by population, health state, and methodology.  Results: Twenty-three articles reported on studies in Asia, including South Korea (8), China (5), Thailand (3), Taiwan (2), India, Japan, Malaysia, Singapore, and Vietnam (1 each). Nearly all studies (20/23) reported EQ-5D utilities and only two used direct methods of elicitation; all utilities were elicited from patients experiencing the conditions rather than general population respondents. Seventeen studies reported utility values for stroke, 12 studies for ACS, and no studies reported on heart failure. Average utilities ranged widely for stroke (-1.99–0.96) and ACS (0.11–1). These wide ranges were seen with most methods of elicitation (EQ-5D [n= 20]: -0.14–1; standard gamble [n= 3]: -1.99–0.72; HUI-3 [n= 1]: -0.23–0.62). SF-6D range was narrow (0.68–0.69) with all values from the same ACS population (n= 3 papers). In stroke, severe disease was associated with lower utility values (-1.57–0.49; n= 3) than mild disease (0.62 to 0.96; n= 4); disease severity was not reported for ACS.  Conclusions: This SLR identified a wide range of utility values for stroke and ACS in Asia. Method of elicitation and severity of disease may impact utility values. Substantial data gaps were observed, particularly for heart failure, levels of disease severity for ACS, and direct methods of utility elicitation; further study is needed to determine whether data from outside Asia can be used to fill such gaps. PCV40 A Systematic Review Comparing Studies of Cardiovascular Event Utilities by Geographic Region Blieden M1, Szatkowski A1, Cheng L2, Gandra SR3 1Evidera, Lexington, MA, USA, 2Amgen, Inc., Thousand Oaks, CA, USA, 3Amgen Inc., Thousand Oaks, CA, USA

Objectives: This study aimed to compare utilities for stroke, acute coronary syndrome (ACS), and heart failure in Asia with those in other geographic regions.  Methods: A systematic literature review was conducted to identify English-language articles in Embase, PubMed, and grey literature published between 1992 and August 2015 using keywords for cardiovascular events and utilities. Primary studies reporting utilities for stroke, ACS (including myocardial infarction and angina), and heart failure in adults were included. Trends in utilities by population, health state, and methodology were evaluated.  Results: Among the 290 articles included, studies from Europe (135), Canada/US (86), Asia (23), and Australia (12) were frequent. Across regions, stroke was most frequently evaluated. In Asia, no articles reported utilities for heart failure, while many evaluated stroke (74%) and ACS (52%). In the other regions, cardiovascular conditions were evaluated with similar frequency (stroke: 42%–56%; heart failure: 25%–43%; ACS: 30%–42%). In all four regions, EQ-5D was the most common method of utility elicitation, but was used more often in Asia (87%) and Europe (87%) than in Canada/US (42%) and Australia (50%). Direct methods of utility elicitation were used more often in Canada/US (35%) than the other regions (10%–16%). All Asian and Australian studies were conducted in patients with the disease, whereas in Canada/US and Europe 8%–9% of articles elicited utilities from general population respondents or carers. Ranges of utility values were wide in all regions. When reported, disease severity was associated with lower utilities in all regions; ranges for mild, moderate, and severe stroke and heart failure were similar across regions.  Conclusions: Across regions, utilities were elicited using different methodologies, but ranges by disease severity were similar. Regional gaps in utility data can be filled using data from other countries with attention to methods, disease severity, and time since event.

PCV41 Satisfaction Level of Patients, Physicians, and Private Primary Healthcare Center Managers with Chronic Disease Management Program in Indonesia Sinuraya RK, Abdulah R, Diantini A, Suwantika AA Universitas Padjadjaran, Sumedang, Indonesia

Objectives: Chronic Disease Management Program (CDMP) is a healthcare system that was conducted by Healthcare and Social Security Agency in Indonesia to improve patients’ quality of life. The aim of this study was to analyze level satisfaction of patients, physicians, and private Primary Healthcare Centers (PHCs) with CDMP, focusing on hypertension care.  Methods: This study was conducted on 1 November until 5 December 2015 in 7 private PHCs in Bandung City, Indonesia. A cross sectional study was conducted to measure patient satisfaction with PSQ-18 on

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143 CDMP patients with hypertension. A total number of 8 physicians and 7 private PHC managers were involved in this study. Level satisfaction of physicians and private PHC managers were observed by using a qualitative study through in-depth interviews.  Results: Patient satisfaction was estimated to be 68.52±8.54, which could be interpreted that patient satisfy with CDMP. In-depth interviews showed that physicians did not satisfy with CDMP due to several factors (e.g.,unintegrated prescription systems, lack of medicines, uncompleted laboratory facilities, lack of physicians, and lack of collaboration between primary and secondary healthcare system). On the other hand, private PHC managers were quite satisfied with CDMP due to its linearity with other activities in private PHCs.  Conclusions: Level satisfaction of patients with CDMP is quite good, while physicians might not satisfy with this program. In particular, private PHC managers confirmed that they are satisfied with this program.

PCV42 The use of Alhijama as Complimentary Treatment in Hypertension Ibrahim I1, Hassali MA2, Saleem F1 Sains Malaysia, Penang, Malaysia, 2School of pharmaceutical sciences, Universiti Sains Malaysia, Penang, Malaysia

1Universiti

Objectives: Alhijama, cupping in western cultures, is a medical practice of the Arabs which was mentioned in Islamic teaching. It includes drawing the blood from specific parts of the human body through the use of special equipment. Our study aims to evaluate the use of Alhijama among hypertensive patients and find predictors associated with this practice.  Methods: A cross-sectional study, using a validated questionnaire for gathering data, was carried out at Al-karama teaching hospital in Baghdad (the capital of Iraq) from July to December 2015. A convenience sampling technique was adopted to recruit the hypertensive patients. Descriptive measures were used to differentiate the study participants and their responses.  Results: Out of 400 hypertensive patients, the use of Alhijama was prevalent among 185 patients (46.3%). Factors influencing the use of Alhijama were traditions, social relationships, religious beliefs, and low cost therapy. There was a significant effect of patients’’ characteristics on the use of Alhijama (P< 0.001). Gender; educational levels; duration of hypertension; and comorbidities were the key predictors of Alhijama practice.  Conclusions: The self-use of Alhijama was prevalent among hypertensive patient to control their blood pressure. This was affected by the cultural effect, social relationships, Islamic recommendations and cost of the treatment. The self-use of Alhijama was affected by the patients’ characteristics. Understanding patients’ self-treatment and practices is is of great importance as long as patient’s safety and interaction with the standard prescribed treatment are of the major concerns.

PCV43 A Review of Studies of Health-Related Quality of Life Performed in Chinese-Speaking Ischemic Heart Disease Patients Luan L, Hu H, Li SC University of Newcastle, Callaghan, NSW, Australia

Objectives: To review published studies of use of Health-related Quality of Life instruments on ischemic heart diseases patients in Chinese-speaking countries/ regions, namely, China, Hong Kong, Taiwan, and Singapore.  Methods: To identify the study of using HRQoL instrument on IHD patients in Chinese-speaking countries/regions, overlapping searching strategy was used for searching two electronic databases: PubMed and EMBASE during 1st January1990 to 30th September 2015. After culling, the identified publications were analyzed and categorized according to the publication dates, the conducting location of the study, the disease being studied, and nature of the study (i.e., whether validation study or application study).  Results: There were 89 publications identified as satisfying the inclusion criteria for review. Among these studies, most of them were conducted in China (n= 64, 73%). Considering the nature of study, 14 studies (16%) were for validation of HRQoL instruments, and most validation studies were conducted in China (n= 8, 57%) during 2006-2015. There were 23 generic and 10 disease-specific instruments applied and validated in the studies, the most commonly used instrument were SF-36 and MLHFQ. Overall, the number of studies using HRQoL instruments has been increasing in recent years, especially in China. But there were only one generic instrument (SF-36), one chronic disease-specific instrument (QLICD-GM), and one IHD-specific instrument (QLICD-CHD)validated in IHD patients in China; and QLICDCHD was validated only in limited number of inpatients. This showed a lack of adequately validated IHD-specific instrument for both inpatients and outpatients in China.  Conclusions: One of the reasons for the increasing number of studies about validation and application of instruments in IHD patients is most likely due to the awareness on importance of HRQoL by regulatory and clinical communities worldwide. Considering the substantial negative impact of IHD from economical, clinical and humanistic perspectives, further research should be performed on the validation and application of IHD-specific instruments in China. PCV44 Psychometric Validation of Anti-Clot Treatment Scale in Japanese Patients with A trial Fibrillation Cano S1, Koretsune Y2, Kumagai K3, Uchiyama S4, Yamashita T5, Yasaka M6, Akiyama S7, Briere J8, Sakaguchi T9, Okayama Y9, Watanabe Fujinuma E7 1Modus Outcomes, Stotfold, UK, 2National Hospital Organization, Osaka National Hospital, Osaka, Japan, 3Fukuoka Sanno Hospital, Fukuoka, Japan, 4Sanno Hospital, Tokyo, Japan, 5The Cardiovascular Institute, Tokyo, Japan, 6Kyushu Medical Center, Fukuoka, Japan, 7Bayer Yakuhin, Ltd., Tokyo, Japan, 8Bayer Pharma AG, Berlin, Germany, 9Bayer Yakuhin, Ltd., Osaka, Japan

Objectives: The Anti-Clot Treatment Scale (ACTS) is a validated patient-reported outcome (PRO) instrument of satisfaction with anticoagulant treatment, consisting two scales: 12-item ACTS Burdens; 3-item ACTS Benefits. A Japanese-language