Abstract P335: Patient Preferences For Renal Denervation In Uncontrolled Hypertension: The RADIANCE PREFER Study

Abstract

Objective: Blood pressure control is a challenge for patients for reasons including adherence, medication side effects, poor access to healthcare, and inconvenience of long-term treatment. Renal denervation is a treatment option that lowers blood pressure in combination with lifestyle modifications and medications, but it requires a minimally invasive procedure. This study assessed how patients make choices between treatments, and quantified their willingness to undergo renal denervation. Methods: An online discrete choice experiment (DCE) was completed by US adults with uncontrolled hypertension despite being prescribed ≥1 medication. In 10 DCE tasks, participants chose between two hypothetical treatments defined by the 10-year cardiovascular (CV) risk, current treatments (procedure/number of pills per day), durability/need for future treatments (additional procedure or pills), and risks of mild-to-moderate and serious adverse events. The attributes were developed through a targeted literature review, 10 qualitative interviews, and FDA feedback, and were refined through 5 cognitive pilot interviews. DCE data were analyzed using mixed logit models which were used to simulate treatment uptake in different scenarios. Results: Participants (n=258) were 62% female, 40% non-white, and from multiple regions of the US, with a majority from the South (63%). Mean (SD) age was 53 (12) years and BMI was 33 (10) kg/m 2 . All participants were currently taking ≥1 pill/day. Participants put the most weight on CV risk when deciding between treatment options. Given the same number of pills, 42% would choose an interventional treatment if it reduced their 10-year CV risk by 5% more than medication alone. In addition, 42% of patients would prefer a one-time invasive procedure versus taking an additional pill if the procedure had the same effect on CV risk as medication alone. Conclusions: A substantial number of patients taking medication for hypertension would be willing to undergo renal denervation to reduce their CV risk or to avoid an increase in their pill burden.