PRS69 Patient Preferences Research in Respiratory SLEEP Medicine - a Systematic Review

Abstract

Patient engagement is becoming more relevant factor in many healthcare systems around the globe. Especially in chronic diseases, it is seen as an important factor in increasing effectiveness of health intervention. A key element for patient centered design of health intervention is knowledge about patient preferences regarding treatment in general and available alternatives. Objective of this study was to evaluate state of research on patient preferences for treatment of obstructive sleep apnea. Eligibility criteria were defined and searches in MEDLINE and Google Scholar conducted. Between 01/2000 and 05/2020, ten publications were identified, which enrolled between 22 and 444 subjects. Most common methods were (semi-) structured interviews (n=5), followed by Discrete Choice Experiments (n=4) and focus group interviews (n=1). Research objective was most commonly identification of patient preferences. However, only one study evaluated revealed preferences. All others analyzed stated preferences. Though OSA is a highly prevalent disease, affecting more than 425 mio. people worldwide, only limited evidence is available on patients’ preferences. Identified studies were of methodological heterogeneity and limited validity due to small sample sizes. DCE, which are considered gold-standard in patient preferences research, were used in less than half of the studies and were mainly looking at smaller populations. Relevant factors, influencing patient preferences and projected benefit, were long-term outcome, side effects, short-term outcome and negative influence on quality of life. Patient preferences in respiratory sleep medicines and its most relevant condition OSA, are not well understood. Published research identified certain utilities, which might affect preferences and decision making of OSA patients. As some are related to health system specific characteristics, they cannot be generalized for all settings. In addition, available studies looked only at some available therapeutic alternative, which do not adequately reflect the recent treatment landscape. There is a high need for additional research on this matter.