Abstract
IntroductionThe patient’s perspective is becoming increasingly important in clinical and policy decisions. In this study, we aimed to evaluate the preferences of patients with, or at risk of, osteoporosis for medication attributes, and to establish how patients trade between these attributes.MethodsA discrete choice experiment survey was designed and patients were asked to choose between two hypothetical unlabelled drug treatments (and an opt-out option) that vary in five attributes: efficacy in reducing the risk of fracture, type of potential common side-effects, mode and frequency of administration and out-of-pocket costs. An efficient experimental design was used to construct the treatment option choice sets and a mixed logit panel data model was used to estimate patients’ preferences and trade-offs between attributes.ResultsA total of 257 patients with, or at risk of, osteoporosis completed the experiment. As expected, patients preferred treatment with higher effectiveness and lower cost. They also preferred either an oral monthly tablet or 6-month subcutaneous injection above weekly oral tablets, 3-month subcutaneous, 3-month intravenous or yearly intravenous injections. Patients disliked being at risk of gastro-intestinal disorders more than being at risk of skin reactions and flu-like symptoms. There was significant variation in preferences across the sample for all attributes except subcutaneous injection.ConclusionsThis study revealed that osteoporotic patients preferred 6-month subcutaneous injection and oral monthly tablet, and disliked gastro-intestinal disorders. Moreover, patients were willing to pay a personal contribution or to trade treatment efficacy for better levels of other attributes. Preferences for treatment attributes varied across patients and this highlights the importance of clinical decision-making taking individual preferences into account to improve osteoporosis care.
Highlights
The patient’s perspective is becoming increasingly important in clinical and policy decisions
Discrete choice experiment A discrete choice experiment (DCE) describes an intervention by its attributes and reports how patient’s preference for an intervention are influenced by the type and levels of these attributes [7]
Eleven questionnaires were excluded because the patient did not complete at least five choice sets in the DCE task
Summary
The patient’s perspective is becoming increasingly important in clinical and policy decisions. Information about what patients need and prefer, and how they value various aspects of a health intervention can be useful when designing and evaluating healthcare programs [1]. A better understanding of patients’ preferences for treatment can help health professionals to improve disease management. Addressing patients’ concerns with treatment and involving them in clinical decision-making may improve adherence [1]. Patients increasingly want to be informed by their doctors, and to be active in clinical decision-making [3,4]. Discrete choice experiments (DCEs) have been increasingly used to elicit patients’ preferences for healthcare [5,6]. DCEs can quantify the relative importance of the various attributes that characterize a treatment and allow the trade-offs that respondents make between these to be quantified [7]
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