scholarly journals Patient preferences on rheumatoid arthritis second-line treatment: A discrete choice experiment of Swedish patients

2020 ◽  
Author(s):  
Karin Schölin Bywall ◽  
Ulrik Kihlbom ◽  
Mats Hansson ◽  
Marie Falahee ◽  
Karim Raza ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Side Effects ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Choice Experiment ◽  
Route Of Administration ◽  
Second Line ◽  
Treatment Characteristics ◽  
Frequency Of Use

Abstract Background: Preference assessments of patients with rheumatoid arthritis can support clinical therapeutic decisions for including biologic and targeted synthetic medicines to use. This study assesses patient preferences for attributes of second-line therapies and heterogeneity within these preferences to estimate the relative importance of treatment characteristics and to calculate the minimum benefit levels patients require to accept higher levels of side effects.Methods: Between November 2018 to August 2019, patients with rheumatoid arthritis were recruited to a survey containing demographic and disease-related questions as well as a discrete choice experiment to measure their preferences for second-line therapies using biologics or Janus kinases inhibitors. Treatment characteristics included were route of administration, frequency of use, probability of mild short-term side effects, probability of side effects changing appearance, probability of psychological side effects, probability of severe side effects, and effectiveness of treatment.Results: A total of 358 patients were included in the analysis. A latent class analysis revealed three preference patterns. 1) Treatment effectiveness as the single most important attribute. 2) Route of administration as the most important attribute, closely followed by frequency of use and psychological side effects. 3) Severe side effects as the most important attribute followed by psychological side effects. In addition, disease duration and mild side effects influenced the patients’ choices.Conclusion: Respondents found either effectiveness, route of administration or severe side effects as the most important attribute. Patients noting effectiveness as most important were more willing than other patients to accept higher risks of side effects.

scholarly journals Patient preferences on rheumatoid arthritis second-line treatment: a discrete choice experiment of Swedish patients

2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Karin Schölin Bywall ◽  
Ulrik Kihlbom ◽  
Mats Hansson ◽  
Marie Falahee ◽  
Karim Raza ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Side Effects ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Choice Experiment ◽  
Route Of Administration ◽  
Second Line ◽  
Treatment Characteristics ◽  
Frequency Of Use

Abstract Background Preference assessments of patients with rheumatoid arthritis can support clinical therapeutic decisions for including biologic and targeted synthetic medicines to use. This study assesses patient preferences for attributes of second-line therapies and heterogeneity within these preferences to estimate the relative importance of treatment characteristics and to calculate the minimum benefit levels patients require to accept higher levels of side effects. Methods Between November 2018 to August 2019, patients with rheumatoid arthritis were recruited to a survey containing demographic and disease-related questions as well as a discrete choice experiment to measure their preferences for second-line therapies using biologics or Janus kinases inhibitors. Treatment characteristics included were route of administration, frequency of use, probability of mild short-term side effects, probability of side effects changing appearance, probability of psychological side effects, probability of severe side effects and effectiveness of treatment. Results A total of 358 patients were included in the analysis. A latent class analysis revealed three preference patterns: (1) treatment effectiveness as the single most important attribute, (2) route of administration as the most important attribute, closely followed by frequency of use and psychological side effects and (3) severe side effects as the most important attribute followed by psychological side effects. In addition, disease duration and mild side effects influenced the patients’ choices. Conclusion Respondents found either effectiveness, route of administration or severe side effects as the most important attribute. Patients noting effectiveness as most important were more willing than other patients to accept higher risks of side effects.

scholarly journals Patient preferences on rheumatoid arthritis second-line treatment: A discrete choice experiment of Swedish patients

2020 ◽  
Author(s):  
Karin Schölin Bywall ◽  
Ulrik Kihlbom ◽  
Mats Hansson ◽  
Marie Falahee ◽  
Eva Baecklund ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Side Effects ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Choice Experiment ◽  
Second Line ◽  
Jak Inhibitors ◽  
Mode Of Administration ◽  
Treatment Characteristics

Abstract Background Preference assessments of patients with rheumatoid arthritis (RA) help inform clinical therapeutic decisions for including biologic and targeted synthetic drugs to use. This study assesses patient preferences for biologics or Janus kinases (JAK) inhibitors and heterogeneity within these preferences to estimate the relative importance of treatment characteristics and to calculate the minimum benefit levels patients require to accept higher levels of side effects. Methods Between November 2018 to August 2019, patients were recruited to participate in a survey containing demographic and disease-related questions as well as a Discrete Choice Experiment to measure their preferences for second-line therapies using biologics or JAK inhibitors. Treatment characteristics (attributes) included in the DCE were mode of administration, frequency of use, probability of mild short-term side effects, probability of side effects affecting appearance, probability of psychological side effects, probability of severe side effects, and effectiveness of treatment. Results A total of 358 patients were included in the analysis. Latent class analysis revealed three preference patterns. When choosing treatment, the respondents found either effectiveness of treatment, mode of administration, or probability of severe side effects as most important. In addition, disease duration and mild side effects influenced the patients’ choices. Conclusion Respondents found either effectiveness, severe side effects, or mode of administration as the most important attribute. Patients noting effectiveness as most important were more willing than other patients to accept higher risks of side effects.

scholarly journals Patient preferences on rheumatoid arthritis second-line treatment: A discrete choice experiment of Swedish patients

2020 ◽  
Author(s):  
Karin Schölin Bywall ◽  
Ulrik Kihlbom ◽  
Mats Hansson ◽  
Marie Falahee ◽  
Karim Raza ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Side Effects ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Choice Experiment ◽  
Second Line ◽  
Jak Inhibitors ◽  
Mode Of Administration ◽  
Treatment Characteristics

Abstract Background: Preference assessments of patients with rheumatoid arthritis (RA) help inform clinical therapeutic decisions for including biologic and targeted synthetic drugs to use. This study assesses patient preferences for biologics or Janus kinases (JAK) inhibitors and heterogeneity within these preferences to estimate the relative importance of treatment characteristics and to calculate the minimum benefit levels patients require to accept higher levels of side effects.Methods: Between November 2018 to August 2019, patients were recruited to participate in a survey containing demographic and disease-related questions as well as a Discrete Choice Experiment to measure their preferences for second-line therapies using biologics or JAK inhibitors. Treatment characteristics (attributes) included in the DCE were mode of administration, frequency of use, probability of mild short-term side effects, probability of side effects affecting appearance, probability of psychological side effects, probability of severe side effects, and effectiveness of treatment.Results: A total of 358 patients were included in the analysis. Latent class analysis revealed three preference patterns. When choosing treatment, the respondents found either effectiveness of treatment (34%), mode of administration (28%), or probability of severe side effects as most important (38%). In addition, disease duration and mild side effects influenced the patients’ choices.Conclusion: Respondents found either effectiveness, severe side effects, or mode of administration as the most important attribute. Patients noting effectiveness as most important were more willing than other patients to accept higher risks of side effects.

scholarly journals Anticoagulation Treatment in Cancer-Associated Venous Thromboembolism: Assessment of Patient Preferences Using a Discrete Choice Experiment (COSIMO Study)

2020 ◽  
Author(s):  
Nils Picker ◽  
Agnes Y. Lee ◽  
Alexander T. Cohen ◽  
Anthony Maraveyas ◽  
Jan Beyer-Westendorf ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Oral Administration ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Choice Experiment ◽  
Oral Anticoagulants ◽  
Daily Intake ◽  
Anticoagulation Therapy ◽  
Route Of Administration

Abstract Introduction Clinical guidelines recommend anticoagulation therapy for the treatment of cancer-associated venous thromboembolism (VTE), but little is known about preferences. Therefore, the objective of this discrete choice experiment (DCE) was to elucidate patient preferences regarding anticoagulation convenience attributes. Methods Adult patients with cancer-associated VTE who switched to direct oral anticoagulants were included in a single-arm study (COSIMO). Patients were asked to decide between hypothetical treatment options based on a combination of the following attributes: route of administration (injection/tablet), frequency of intake (once/twice daily), need for regular controls of the international normalized ratio (INR) at least every 3 to 4 weeks (yes/no), interactions with food/alcohol (yes/no), and distance to treating physician (1 vs. 20 km) as an additional neutral attribute. DCE data were collected by structured telephone interviews and analyzed based on a conditional logit regression. Results Overall, 163 patients (mean age 63.7 years, 49.1% female) were included. They strongly preferred oral administration compared with self-injections (importance of this attribute for overall treatment decisions: 73.8%), and a treatment without dietary restrictions (11.8%). Even if these attributes were less important (7.2% and 6.5%, respectively), patients indicated a preference for a shorter distance to the treating physician and once-daily dosing compared with twice-daily intake. “Need for regular controls of INR at least every 3 to 4 weeks” showed no significant impact on the treatment decision (0.7%). Conclusion This study showed that treatment-related decision making in cancer-associated VTE, assuming comparable effectiveness and safety of anticoagulant treatments, is predominantly driven by “route of administration,” with patients strongly preferring oral administration.

scholarly journals Do Patient Preferences Align With Value Frameworks? A Discrete-Choice Experiment of Patients With Breast Cancer

2020 ◽  
Vol 5 (1) ◽  
pp. 238146832092801
Author(s):  
Ilene L. Hollin ◽  
Juan Marcos González ◽  
Lisabeth Buelt ◽  
Michael Ciarametaro ◽  
Robert W. Dubois
Keyword(s):  
Breast Cancer ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Treatment Efficacy ◽  
Choice Experiment ◽  
Route Of Administration ◽  
Systematic Evaluation ◽  
Individual Level ◽  
Preference Weights

Purpose. Assess patient preferences for aspects of breast cancer treatments to evaluate and inform the usual assumptions in scoring rubrics for value frameworks. Methods. A discrete-choice experiment (DCE) was designed and implemented to collect quantitative evidence on preferences from 100 adult female patients with a self-reported physician diagnosis of stage 3 or stage 4 breast cancer. Respondents were asked to evaluate some of the treatment aspects currently considered in value frameworks. Respondents’ choices were analyzed using logit-based regression models that produced preference weights for each treatment aspect considered. Aggregate- and individual-level preferences were used to assess the relative importance of treatment aspects and their variability across respondents. Results. As expected, better clinical outcomes were associated with higher preference weights. While life extensions with treatment were considered to be most important, respondents assigned great value to out-of-pocket cost of treatment, treatment route of administration, and the availability of reliable tests to help gauge treatment efficacy. Two respondent classes were identified in the sample. Differences in class-specific preferences were primarily associated with route of administration, out-of-pocket treatment cost, and the availability of a test to gauge treatment efficacy. Only patient cancer stage was found to be correlated with class assignment ( P = 0.035). Given the distribution of individual-level preference estimates, preference for survival benefits are unlikely to be adequately described with two sets of preference weights. Conclusions. Although value frameworks are an important step in the systematic evaluation of medications in the context of a complex treatment landscape, the frameworks are still largely driven by expert judgment. Our results illustrate issues with this approach as patient preferences can be heterogeneous and different from the scoring weights currently provided by the frameworks.

scholarly journals Capturing Adult Patient Preferences Toward Benefits and Risks of Second-Line Antihyperglycemic Medications Used in Type 2 Diabetes: A Discrete Choice Experiment

2020 ◽  
Vol 44 (1) ◽  
pp. 6-13
Author(s):  
Jennifer R. Donnan ◽  
Karissa Johnston ◽  
Eugene Chibrikov ◽  
Carlo A. Marra ◽  
Kris Aubrey-Bassler ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Adult Patient ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Choice Experiment ◽  
Second Line

scholarly journals Patient Preferences for Biologic Agents in Rheumatoid Arthritis: A Discrete-Choice Experiment

2013 ◽  
Vol 16 (2) ◽  
pp. 385-393 ◽  
Author(s):  
Federico Augustovski ◽  
Andrea Beratarrechea ◽  
Vilma Irazola ◽  
Fernando Rubinstein ◽  
Pablo Tesolin ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Choice Experiment ◽  
Biologic Agents

scholarly journals BL2 PATIENT PREFERENCES FOR BIOLOGIC AGENTS IN RHEUMATOID ARTHRITIS: A DISCRETE CHOICE EXPERIMENT

2010 ◽  
Vol 13 (7) ◽  
pp. A243
Author(s):  
F Augustovski ◽  
A Beratarrechea ◽  
V Irazola ◽  
F Rubinstein ◽  
P Tesolin ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Choice Experiment ◽  
Biologic Agents

scholarly journals P176 Patient preferences in steroid resistant ulcerative colitis – a discrete choice experiment survey

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S249-S249
Author(s):  
N Wickramasekera ◽  
P Shackley ◽  
E Coates ◽  
A Barr ◽  
M Lee ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Side Effects ◽  
Success Rate ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Choice Experiment ◽  
Regression Analyses ◽  
Poor Control ◽  
Treatment Characteristics ◽  
At Home

Abstract Background Understanding patient preferences in those who are not responding to steroids for ulcerative colitis is important in informing treatment choices. This study aimed to understand the relative importance of treatment characteristics to patients by conducting a discrete choice experiment (DCE). Methods Patients completed a two-part online survey. Participants were shown 12 DCE tasks – a series of side by side comparison of competing, hypothetical treatment characteristics describing effectiveness, remission, speed of response, route of administration and safety and asked to select a preferred treatment. Disease control was assessed by the IBD-control-8 questionnaire (poor control < 13). Participants also completed a ranking exercise where patients were asked to rank four commonly used treatments (Adalimumab, Infliximab, Tofacitinib, and Vedolizumab,) in order of preference. Survey responses were analysed using descriptive statistics and regression analyses. Results 115 patients completed the survey (mean age 45 years; 52% female; median time since diagnosis 10 years). 107 (93%) had previously received steroids; 81 (70%) thiopurines and 81 (70%) biological therapies or tofacitinib. 51 (45%) reported poor control of ulcerative colitis. Figure 1 shows the results of the regression analyses where all treatment characteristics had a significant influence on patients’ treatment choice. Patient preferences were strongest for lower side effects, for example, compared to a treatment that had very common side effects, patients were more likely to take a treatment that had very rare side effects (ß 2.937, p<0.01) even if very rare side effects are usually more severe. Patients preferred a treatment with higher likelihood of induction of response, but they were unable to differentiate between 50% success rate and 60% success rate. Higher levels of remission (ß 0.065, p<0.01) and faster acting treatments were preferred (ß -0.145, p<0.01). Taking a pill daily at home (ß 0.848, p<0.01) or injections at home every 8 weeks (ß0.541, p<0.01) were preferable compared to infusions every 8 weeks. Notably, there was no significant difference between infusion, every 8 weeks at hospital compared to injection, every 2 weeks, at home (ß -0.029, p= 0.85). When asked to rank four commonly used biologics, the most preferred treatment was Infliximab (38%) and Tofacitinib (38%), followed by Vedolizumab (17%) and Adalimumab (6%). Conclusion Quantifying preferences through DCEs helps to identify and prioritise treatment characteristics that are important to patients. The results could be used to improve discussions between patients and clinicians when reviewing treatment options.

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