Is patients’ perspective incorporated when choosing an inhaler device for COPD treatment? A framework value assessment based in Multi Criteria Decision Analysis

Abstract

PURPOSE: To develop a MCDA framework for the value assessment of inhaler devices in COPD from patients’ perspective. METHODS: A literature review was conducted to identify relevant criteria in inhaler devices in COPD from patients’ perspective. Findings were validated in two workshops with COPD patients and COPD healthcare professionals. The final criteria were validated with 68 COPD patients and applied to different inhaler devices, using a specific questionnaire. All criteria were scored by patients using an ordinal scale of 5 points. Final criteria were weighted based on their relative importance by a subgroup of patients. RESULTS: Pilot MCDA framework included 11 criteria. After the workshop with HCPs, 2 additional criteria were included. In the field work validation, one criterion was excluded, and another was adapted. The final framework consisted of 12 criteria grouped into 3 dimensions (comfort and ease of use, degree of technical innovation and patient satisfaction). Criteria were weighed by importance: visible dose counter, confirmation of correct dose taking, easy manipulation, comfortable mouthpiece, intuitive mechanism of use, duration of the device, preloaded device, dose-taking reminder, ergonomic shape, no need of hand-breath coordination, cover remains attached while opened and steps for dose taking. The devices more positively valued by patients were Multidose Dry Powder Inhalers, followed by Monodose Dry Powder Inhalers, Soft Mist Inhalers and pressurised Metered Dose Inhalers. CONCLUSIONS: The developed MCDA framework can help in decision-making, allowing to assess the value of inhaler devices from the patients’ perspective and to select the inhaler device that might suit better each COPD patient. Keywords: MCDA, COPD, patient perspective, inhaler device.