The Relative Importance of Health Related Quality of Life and Prescription Insurance Coverage in the Decision to Pharmacologically Manage Symptoms of Overactive Bladder

Abstract

Patient decisions to seek treatment for overactive bladder are influenced by the impact of the condition on health related quality of life and the presence of prescription insurance coverage. This study uses conjoint analysis to examine the relative importance of health related quality of life dimensions of the overactive bladder questionnaire and the presence of prescription insurance coverage on patient preference for treatment. Patient preferences were elicited using a study questionnaire that included 9 hypothetical profiles containing an orthogonal array of attributes relating to coping with symptoms, symptom concern, sleep disturbances, problems with social interactions and prescription insurance coverage. This questionnaire was administered to 150 patients with self-reported symptoms of overactive bladder. Patients responded to each profile with the likelihood that they would prefer drug therapy to control overactive bladder symptoms versus doing nothing. A total of 133 usable responses were obtained from participants. Analysis was conducted with a linear random effects model. Of the 5 included attributes prescription insurance coverage was the most important attribute followed by sleep disturbances, symptom concern, social interaction problems and coping. Responses obtained from attribute ratings using visual analog scaling and a holdout profile demonstrated study validity. Prescription insurance coverage and sleep disturbances are important considerations underlying patient preferences for the treatment of overactive bladder.