S1. Which of the following age categories do you fall into? Please select one answer only years of age years of age years of age

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1 Supplemental Materials Supplemental Methods Patient Survey We are presently conducting a market research study to help us better understand some of the challenges experienced by patients taking anticoagulants (blood- thinners) for Stroke Prevention in Atrial Fibrillation. The results of this survey will help improve the services and quality of information that may be provided to patients like you. S. Which of the following age categories do you fall into? Please select one answer only 8- years of age 5-6 years of age 65-7 years of age 75 or older PROGRAMMER NOTE: Allow one answer only S. Which province do you currently reside in? New Brunswick Ontario 6 Nova Scotia Manitoba 7 Newfoundland Saskatchewan 8 PEI Alberta 9 Quebec 5 BC 0 PROGRAMMER NOTE: Allow one answer only S. Please select your gender: Male Female PROGRAMMER NOTE: Allow one answer only PROGRAMMER NOTE: Randomize treatments PROGRAMMER NOTE: Allow one answer only S. Which of the following anticoagulant (blood- thinner) treatments are you currently taking? Please select one answer only Treatments Pradaxa/dabigatran etexilate

2 Xarelto/rivaroxaban Coumadin/Warfarin Eliquis/apixaban None of these 5 PROGRAMMER NOTE: If at S. None of these Term, otherwise go to S.5 S5. How often do you take (pipe in S.)? Dosing Frequency Once daily Twice daily PROGRAMMER NOTE: For Other force answer, Allow for one answer only S6. What condition are you taking (pipe in S. treatment) for? o Don t know/do not recall PROGRAMMER NOTE: Text box and check box mutually exclusive S7. Are you taking (pipe in S. treatment) for? Stroke Prevention in Atrial Fibrillation (AF) / Irregular heart beats Other reason PROGRAMMER NOTE: Allow for one answer only, if Other is selected screen out, otherwise go to S.8 S8. Thank you for your interest. Based on your answers, you qualify to answer this survey. Please note that you may only take this survey ONCE. Please answer all remaining questions to the best of your ability. Please note that as part of our normal procedure, we are required to notify the manufacturer of the medication of any side effects that may be mentioned during this survey. Would you like to continue with this survey?

3 Yes, I would like to proceed No, I don t want to proceed PROGRAMMER NOTE: If S.8 = No (), Term, otherwise continue the interview S9. Are you currently taking other medications for any other conditions? Yes No PROGRAMMER NOTE: If S.9 = Yes ask S.0, otherwise go to next section S0. Please indicate all the medication(s) you are currently taking and the reason(s)/ dosing they are prescribed for: Name of medication(s) Reason(s) for taking this medication(s) Dosing Frequency (e.g. once, twice or three times a day etc.) The following questions will focus on your anticoagulant (blood- thinner) medication: (pipe in S.) Patient Attitudinal Questionnaire. How long have you been taking (Insert drug name of anticoagulant medication S.)? Please select one of the following answers PROGRAMMER NOTE: Please allow one option only Less than 6 months 6 months less than one year - years More than years. Where was (Insert drug name of anticoagulant medication S.) first initiated/prescribed to you?

4 PROGRAMMER NOTE: Please allow one option only In Emergency Room When admitted to a Hospital At a Doctor s Office/Clinic outside of a hospital. Who first started you on this anticoagulant (blood- thinner) (Insert drug name of anticoagulant medication S.) medication? PROGRAMMER NOTE: Please allow one option only Family doctor / GP Cardiologist Neurologist Hematologist Internal medicine doctor Emergency room doctor Do not recall Thinking back to when you were first prescribed (insert drug name of anticoagulant medication S.), which of the following best describes how this particular anticoagulant (blood- thinner) medication was selected for you? Please select one answer only PROGRAMMER NOTE: Please allow for one answer only Only one blood- thinner medication was discussed by my doctor Several blood- thinner medications were discussed by my doctor I asked for the blood- thinner medication by name and my doctor prescribed it PROGRAMMER NOTE: If Q. = ask Q.5, else go to Q.6 5. Again thinking back to when you were first prescribed (insert drug name of anticoagulant medication S.) when several blood- thinner medications were discussed with your doctor, which of the following best describes how this particular anticoagulant (blood- thinner) medication was finally selected for you? Please select one answer only PROGRAMMER NOTE: Please allow for one answer only

5 My doctor provided me with several choices and I made the final choice My doctor provided me with several choices and he/she made the final choice My doctor provided me with several choices and we made the final choice together 6. Where do you typically go to have your anticoagulant (blood- thinner) medication monitored or managed? PROGRAMMER NOTE: Please allow for one answer only In a Hospital At a Specialty Clinic At a Doctor s Office/Clinic outside of a hospital 7. Prior to taking (insert drug name of anticoagulant medication S.) were you taking a different anticoagulant (blood- thinner) medication? Yes No PROGRAMMER NOTE: If at Q.7 = Yes, ask Q.8 and Q.9, otherwise to go Q.0 8. Which other anticoagulant (blood- thinner) medication(s) were you prescribed prior to taking (insert drug name of anticoagulant medication S.)? Coumadin/Warfarin Pradaxa/dabigatran etexilate Xarelto/rivaroxaban Eliquis/apixaban PROGRAMMER NOTE: Randomize products PROGRAMMER NOTE: Allow for multiple mentions, mask product from S. (or cannot select product from S.) 9. What was the primary reason you were switched to (insert drug name of anticoagulant medication S.)? 5

6 PROGRAMMER NOTE: Please allow one option only Convenient Dosing Cost Coverage by my insurance / provincial health plan Other PROGRAMMER NOTE: For Other we do not want to specify 0. The following are some attributes or features of anticoagulant (blood- thinner) medications. On a scale of to 0 where is not at all important and 0 is extremely important, please rate the following attributes in terms of how important they are to you. PROGRAMMER NOTE: Please randomize order of attributes PROGRAMMER NOTE: Must select one answer for each row Not at all Extremely important important It is safe It has few side effects It is taken once a day The medication doesn t require blood tests The medication is effective It is recommended by my doctor It is recommended by my pharmacist It is easy to get information about the medication if I have questions There is a number that I can call to get access to information about the medication It has a patient support program that provides access to medical staff I can afford to pay for the medication Covered by health plans / public and private Low risk of bleeding Low risk of having a stroke event It has clinical data to support its use The effect of the medication can be reversed in case of emergency surgery It has been in use for decades Thinking of how often you are taking your anticoagulant (blood- thinner) medication how much of an advantage would it be to take it once a day vs. twice a day? PROGRAMMER NOTE: Allow for one answer only There is a significant advantage to take my anticoagulant (blood- thinner) medication once a day over twice a day There is some advantage to take my anticoagulant (blood- thinner) medication once a day over twice a day 5 6

7 There is NO advantage to take my anticoagulant (blood- thinner) medication once a day or twice a day There is some advantage to take my anticoagulant (blood- thinner) medication twice a day over once a day There is a significant advantage to take my anticoagulant (blood- thinner) medication twice a day over once a day. Sometimes patients have questions about their medication after they have filled the prescription. If you had questions about your anticoagulant (blood- thinner) medication after filling the prescription, what/who would be your first source of information? PROGRAMMER NOTE: Allow for one answer only My family doctor A specialist A nurse My pharmacist The internet The number on the package insert My friends / family Using a scale from to 0, where is not at all satisfied and 0 is extremely satisfied, rate your overall satisfaction with (pipe in S), your current anticoagulant (blood- thinner) medication? Level of satisfaction with my anticoagulant (blood- thinner) medication (pipe in S) Not at all satisfied Extremely satisfied In the past month, how many doses of your anticoagulant (blood- thinner) medication (pipe in S) have you missed, if any? If you have not missed any doses, please enter a zero Number of missed doses/past month PROGRAMMER NOTE: Ask Q.5 if Q.>0, else go to Q.6 5. Please select the reason(s) why you may have missed a dose of your anticoagulant (blood- thinner) medication in the past month? Please select all that apply When I am feeling well, I do not take my anticoagulant (blood- thinner) 7

8 medication If I am feeling worse (any side effects) I will stop taking my anticoagulant (blood- thinner) medication I forgot to fill my prescription I forgot to take my medication 6. Why do you think patients, like yourself, may consider stopping their anticoagulant (blood- thinner) medication? 7. Have you ever considered stopping your anticoagulant (blood- thinner) medication? Yes No The Patient will then be directed to the conjoint exercise: 8

9 Supplemental Methods Physician Survey We are presently conducting a market research study regarding current attitudes and treatment practices in the area of anticoagulant medications and we are interested in your opinion. All data generated in this survey will remain anonymous at all times and will be treated in accordance with data protection laws and market research ethical guidelines. Your name will not be mentioned at any time, connected to any data or disclosed to a third party. We look forward to your input and thank you in advance for your participation. S. Please select your province: New Brunswick Ontario 6 Nova Scotia Manitoba 7 Newfoundland Saskatchewan 8 PEI Alberta 9 Quebec 5 BC 0 S. What is your medical specialty? GP/FM Cardiologist IM PROGRAMMER NOTE: If S. is Other, Terminate q re PROGRAMMER NOTE: If S. = code (IM), go to Q.Sa, ELSE go to Q.S Sa. What is your medical subspecialty? Cardiology No subspecialty S. How many years have you been in practice? # of years PROGRAMMER NOTE: If S. is < or >5, Terminate q re 9

10 S. Currently what percentage of your time do you spend practicing in each of the following locations? Doctor, the total of all these options must sum to 00% PROGRAMMER NOTE: Total must sum to 00% % of time Academic / teaching hospital Community hospital Private practice TOTAL MUST SUM TO 00% 00% S5. What percentage of your total practice does stroke prevention in atrial fibrillation (AF) represent? % of total practice PROGRAMMER NOTE: Do not allow for zero S6. In the past year, in how many of your patients (newly diagnosed and follow up) did you manage their anticoagulant therapy for stroke prevention in atrial fibrillation? Doctor, please do not consider patients taking anticoagulants for DVT/PE or other reasons. # of patients Newly diagnosed patients Follow- up patients Total # of patients PROGRAMMER NOTE: If total of S5<0, Terminate q re S7. Doctor, the company sponsoring this research requires that we report any suspected adverse events related to their own product(s) mentioned during the research to their Drug Safety Department. Although what you say will, of course, be treated in confidence, should you report a suspected adverse event drug reaction in a specific patient we will need to report this so that our client can learn more about the safety of their medicines. Your identity will not be associated with any other information that you provide during the survey, and the results will be reported in aggregate form. Would you like to proceed with the interview on this basis? o o I would like to proceed and give permission for my contact details to be passed onto the Drug Safety department of the company if an adverse event is mentioned by me during this activity I would like to proceed with the survey but I do not want to give permission for my contact details to be passed onto the Drug Safety department of the company if an adverse event is mentioned by me during this activity o I don't want to proceed and end the interview here 0

11 PROGRAMMING NOTE: If third option selected, End 8. Which anticoagulant medications for stroke prevention in AF are you aware of? PROGRAMMER NOTE: Text box 9. Are you aware of the following anticoagulant medications? Please provide an answer for each medication, whether you have previously mentioned it or not Yes No Xarelto/rivaroxaban Warfarin/Coumadin Pradaxa/dabigatran etexilate Eliquis/apixaban PROGRAMMER NOTE: Randomize products, please allow for one answer per medication If unaware of all (i.e. if code was always selected with all drugs) Terminate PROGRAMMER NOTE: Display each medication physician is aware of at Q. (Yes = code ) 0. Please rate your level of familiarity with each of the following anticoagulant medications using a scale of to 0 where is "not familiar at all" and 0 is "extremely familiar": PROGRAMMER NOTE: Randomize products, please allow for one answer per medication Not at all familiar Extremely familiar Xarelto/rivaroxaban Warfarin/Coumadin Pradaxa/dabigatran etexilate Eliquis/apixaban PROGRAMMER NOTE: Display each medication physician is aware of at Q. (Yes = code ). Thinking of the last 0 patients who were prescribed anticoagulants for stroke prevention in AF, for how many did you prescribe each of the following products? PROGRAMMER NOTE: Total must sum to 0 patients

12 Xarelto/rivaroxaban Warfarin/Coumadin Pradaxa/dabigatran etexilate Eliquis/apixaban Other Anticoagulant (please specify) Other Anticoagulant (please specify) Last 0 patients Total must sum to 0 PROGRAMMER NOTE: Display each medication physician is aware of at Q. (Yes = code ). What is your most preferred anticoagulant therapy for stroke prevention in AF? PROGRAMMER NOTE: Allow for single mention only Xarelto/rivaroxaban Warfarin/Coumadin Pradaxa/dabigatran etexilate Eliquis/apixaban No preference Other Anticoagulant (please specify) 99 PROGRAMMER NOTE: If Q.5 = code 99, go to Q.7, ELSE show Q6. Why is (insert medication at Q.5) your preferred anticoagulant therapy for stroke prevention in AF?. Thinking of your patients on anticoagulants for stroke prevention in AF, what is the percentage of patients initiated by you vs. by other physicians? PROGRAMMER NOTE: Total must sum to 00% Initiated by myself Initiated by another physician (GP/Family Doctor) Initiated by another physician (Cardiologist) Initiated by another physician (Neurologist) Initiated by another physician (Hematologist) Initiated by another physician (Internal Medicine) % of patients on Anticoagulants

13 Initiated by another physician (ER Specialist) Initiated by another physician TOTAL MUST SUM TO 00% 00% 5. Please rate each of the following attributes on their importance when prescribing anticoagulants to your patients for stroke prevention in AF. Please use a 0 point scale where is not at all important and 0 is extremely important. PROGRAMMER NOTE: Please randomize attributes Not at all important Extremely important Attributes It is safe It has few side effects It is once daily The medication doesn t require blood tests The medication is effective I have experience with it It is recommended by pharmacists There is a number that my patients can call to get access to information Having readily accessible patient tools/information for use with my patients My patients can afford the medication It is covered by health plans/ public and private It has low risk of bleeding It does not require transfusion in hospitals It has low risk of having a stroke event The medication has an antidote reversal of anticoagulant for emergency surgery It has been in use for decades It has necessary clinical data to support use in patients It is recommended by the anticoagulant guidelines How much of an advantage would once daily vs. twice daily dosing offer to your patients on anticoagulant therapy for stroke prevention in AF? PROGRAMMER NOTE: Allow for one answer only Once daily dosing of anticoagulant therapy has a significant advantage to my patients over twice daily dosing Once daily dosing of anticoagulant therapy has some advantage 5

14 to my patients over twice daily dosing Once daily dosing of anticoagulant therapy has NO advantage to my patients vs. twice daily dosing Twice daily dosing of anticoagulant therapy has some advantage to my patients over once daily dosing Twice daily dosing of anticoagulant therapy has a significant advantage to my patients over once daily dosing 7. At the time when you are prescribing an anticoagulant medication to your patients for stroke prevention in AF, do you usually discuss any side effects that may be associated with the drug? PROGRAMMER NOTE: Please allow one answer only Yes No PROGRAMMER NOTE: If Q.0 = yes and for each medication aware of at Q. (Yes = code ); ask Q.-, otherwise go to Q.5. Display Q to Q on the same screen. 8. Which specific side effects do you usually discuss when prescribing Xarelto/rivaroxaban to your patients for stroke prevention in AF? 9. Which specific side effects do you usually discuss when prescribing Warfarin/Coumadin to your patients for stroke prevention in AF? 0. Which specific side effects do you usually discuss when prescribing Pradaxa/dabigatran etexilate to your patients for stroke prevention in AF?. Which specific side effects do you usually discuss when prescribing Eliquis/apixaban to your patients for stroke prevention in AF?. What information, other than side effects, do you usually discuss with your patients when prescribing an anticoagulant medication for stroke prevention in AF?

15 . Once patients have been prescribed anticoagulant medications for stroke prevention in AF, should questions arise about their treatment, what or who would be their main source of information? Please indicate the percentage of patients that fall into each of the following options: PROGRAMMER NOTE: Total must sum to 00% PROGRAMMER NOTE: If I do not know is selected, make mutually exclusive Main source of information Their family doctor % of patients on Anticoagulants A specialist A Nurse Their Pharmacist The internet The number on the package insert Family / friends I do not know TOTAL MUST SUM TO 00% 00%. When prescribing anticoagulant medications to your patients for stroke prevention in AF, how is the decision usually made, regarding which anticoagulant medication would be selected? Of the (insert total of S6 number of patients) patients prescribed anticoagulants in the past months, please indicate the percentage of patients that fall into each of the following options: PROGRAMMER NOTE: Total must sum to 00% I provide only the most appropriate medication to the patient I provide several recommendations and discuss the benefits and side effects of each with the patient The patient would come in with information and ask for the medication by name and I would prescribe it % of patients on Anticoagulants for stroke prevention in AF TOTAL MUST SUM TO 00% 00% 5

16 PROGRAMMER NOTE: If Q.7 row > 0 ask Q.8, else go to Q.9 5. Doctor, you mentioned that for (insert % at Q.7 row ) % of your patients you provide several recommendations and discuss the benefits and side effects of each option with these patients to choose the most appropriate anticoagulant medication for stroke prevention in AF. Please indicate the percentage of patients in your practice that fall into each of the following categories: PROGRAMMER NOTE: Total must sum to 00% I provide several recommendations and the patient makes the final choice I provide several recommendations and I make the final choice I provide several recommendations and both the patient and I make the final choice together TOTAL MUST SUM TO 00% % of patients on Anticoagulants for stroke prevention in AF 00% 9a. Thinking about your patients that you manage for stroke prevention in AF, who are on twice daily dosing of anticoagulants, What percentage will skip a dose of their anticoagulant medication if they are feeling well? % of patients on twice daily dosing who will skip a dose of their anticoagulant medication 9b. Now thinking about your patients that you manage for stroke prevention in AF, who are on twice daily dosing of anticoagulants, What percentage will stop taking their anticoagulant medication if they are experiencing side effects? % of patients on twice daily dosing who will stop taking their anticoagulant medication 0a. Also, thinking of your patients that you manage for stroke prevention in AF who are on once daily dosing of anticoagulants, What percentage will skip a dose of their anticoagulant medication if they are feeling well? % of patients on once daily dosing who will skip a dose of their anticoagulant medication 6

17 0b. Now thinking of your patients that you manage for stroke prevention in AF who are on once daily dosing of anticoagulants, What percentage will stop taking their anticoagulant medication if they are experiencing side effects? % of patients on once daily dosing who will stop taking their anticoagulant medication PROGRAMMER NOTE: Display each medication physician is aware of at Q. (Yes = code ). Thinking of one of your patients for whom you would prescribe an anticoagulant for the management of stroke prevention in AF, please describe the patient type for which you would choose (INSERT EACH DRUG from Q) over other anticoagulant medications? Please consider: Age Sex Co- morbidities (based on full medication profile) Lifestyle (e.g. smoker, drinker, etc.) Any other important factors (Please ensure to specify) in your decision to choose this anticoagulant drug for this typical patient. o Have not yet prescribed PROGRAMMNER NOTE: If have not yet prescribed selected, make mutually exclusive PROGRAMMER NOTE: Display each medication physician is aware of at Q. (Yes = code ). Thinking of your patients on anticoagulants for stroke prevention in AF, for what percentage of patients do you intend to prescribe each of the following drugs in the next months? PROGRAMMER NOTE: Total must sum to 00% Xarelto/rivaroxaban Warfarin/Coumadin Pradaxa/dabigatran etexilate Eliquis/apixaban Other Anticoagulant (please specify) Other Anticoagulant (please specify) TOTAL MUST SUM TO 00% % of patients on Anticoagulants for stroke prevention in AF 00% 7

18 The Physician will then be directed to the conjoint exercise: 8

19 Supplemental Methods - Representative question from the conjoint analysis for A) Patients and B) Physicians. 9

20 Supplemental Methods - Representative question from the preference analysis for A) Patients and B) Physicians. 0

21 Supplemental Table. Definitions of features/attributes Feature Definition for Physicians Definition for Patients The effectiveness of the drug (annual stroke free survival; shown in %): Regular blood testing monitoring (Required/Not required): The daily dosing regimen (Once daily/ Twice Daily): Risk of major bleeding event per year (shown in %): Ability to rapidly reverse in emergency circumstances (Yes/No): Decades of clinical experience (Yes/No): Interaction with foods/drugs (High vs. Low): The percentage of patients taking the drug who would be expected to NOT have a stroke in a given year Whether patients are required to undergo regular blood testing to measure drug levels? Once daily (OD), or twice daily (BID) The expected rate of major bleeding in a given year (based on clinical trial data) in patients taking their anticoagulant Whether the anticoagulant effect can be reversed by administration of another agent? Whether there are decades of clinical experience with this drug? Potential for food/drug interactions that are clinically significant, and accordingly may limit the patient s ability to eat certain foods or take other drugs The percentage of people taking the medication who would probably NOT have a stroke in a given year Would you need to have regular blood tests to check medication levels? Is the pill taken once a day, or twice a day? What is the risk of having major bleeding (bleeding that requires medical intervention and/or a trip to a doctor or emergency)? Can the effect of the anticoagulant (blood thinner) be quickly reversed by the administration of another agent or medication? Is there a lot of clinical experience with this medication (have doctors been using it for decades or not)? What is the likelihood that the medication will react with certain foods and limit your ability to eat them when taking it, or interact with other medications you may be on?

22 Supplemental Table. Concomitant Medications Apixaban (n = 9) Dabigatran (n = 9) Rivaroxaban (n = 50) Warfarin (n = 55) Cardiovascular Agents (Net) 90% 78% 8% 8% Beta Blockers 6% % 5% 8% ACE Inhibitors % % 8% 5% Calcium Channel Blockers % 0% % % Antiplatelets 6% 0% 8% % Angiotensin Receptor Blockers % 0% 8% 0% Cardiac Glycosides 6% 6% % % HMG- CoA Reductase Inhibitors 7% % 8% Diuretics (Net) 7% 9% 6% % Proton Pump Inhibitors (Net) 6% 8% % 6% Analgesics (Net) % 0% % 7% Oral Diabetes Medication % 0% 0% 9% CNS Agents (Net) 6% 5% % 8% Antidepressants % 0% 6% 9% Thyroid Hormones (Net) - - 0% % %

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