Decision Making About Disease-Modifying Treatments for Relapsing-Remitting Multiple Sclerosis: Stated Preferences and Real-World Choices.

IF 3.4 3区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Patient-Patient Centered Outcomes Research Pub Date : 2023-09-01 DOI:10.1007/s40271-023-00622-1

Edward J D Webb, David Meads, Ieva Eskytė, Helen L Ford, Hilary L Bekker, Jeremy Chataway, George Pepper, Joachim Marti, Yasmina Okan, Sue H Pavitt, Klaus Schmierer, Ana Manzano

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Abstract

Background: People with relapsing-remitting multiple sclerosis can benefit from disease-modifying treatments (DMTs). Several DMTs are available that vary in their efficacy, side-effect profile and mode of administration.

Objective: We aimed to measure the preferences of people with relapsing-remitting multiple sclerosis for DMTs using a discrete choice experiment and to assess which stated preference attributes correlate with the attributes of the DMTs they take in the real world.

Methods: Discrete choice experiment attributes were developed from literature reviews, interviews and focus groups. In a discrete choice experiment, participants were shown two hypothetical DMTs, then chose whether they preferred one of the DMTs or no treatment. A mixed logit model was estimated from responses and individual-level estimates of participants' preferences conditional on their discrete choice experiment choices calculated. Logit models were estimated with stated preferences predicting current real-world on-treatment status, DMT mode of administration and current DMT.

Results: A stated intrinsic preference for taking a DMT was correlated with currently taking a DMT, and stated preferences for mode of administration were correlated with the modes of administration of the DMTs participants were currently taking. Stated preferences for treatment effectiveness and adverse effects were not correlated with real-world behaviour.

Conclusions: There was variation in which discrete choice experiment attributes correlated with participants' real-world DMT choices. This may indicate patient preferences for treatment efficacy/risk are not adequately taken account of in prescribing. Treatment guidelines must ensure they take into consideration patients' preferences and improve communication around treatment efficacy/risk.

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关于复发缓解型多发性硬化症疾病改善治疗的决策:声明偏好和现实选择。

背景:复发缓解型多发性硬化症患者可以从疾病改善治疗(dmt)中获益。目前有几种dmt，其疗效、副作用和给药方式各不相同。目的:我们旨在通过离散选择实验来测量复发-缓解型多发性硬化症患者对dmt的偏好，并评估哪些陈述的偏好属性与他们在现实世界中服用的dmt的属性相关。方法:从文献综述、访谈和焦点小组中建立离散选择实验属性。在一个离散选择实验中，参与者被展示了两种假设的dmt，然后选择他们是否喜欢其中一种dmt或不接受治疗。混合logit模型是根据参与者的离散选择实验选择计算得出的回答和个人水平的偏好估计得出的。Logit模型用陈述偏好来预测当前现实世界的治疗状态、DMT给药方式和当前DMT。结果:对服用DMT的内在偏好与目前服用DMT相关，对给药方式的偏好与参与者目前服用的DMT的给药方式相关。对治疗效果和不良反应的偏好与现实世界的行为无关。结论:离散选择实验属性与参与者现实世界DMT选择的相关性存在差异。这可能表明在处方中没有充分考虑到患者对治疗效果/风险的偏好。治疗指南必须确保考虑到患者的偏好，并就治疗效果/风险加强沟通。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Patient-Patient Centered Outcomes Research HEALTH CARE SCIENCES & SERVICES-

CiteScore

6.60

自引率

8.30%

发文量

审稿时长

>12 weeks

期刊介绍： The Patient provides a venue for scientifically rigorous, timely, and relevant research to promote the development, evaluation and implementation of therapies, technologies, and innovations that will enhance the patient experience. It is an international forum for research that advances and/or applies qualitative or quantitative methods to promote the generation, synthesis, or interpretation of evidence. The journal has specific interest in receiving original research, reviews and commentaries related to qualitative and mixed methods research, stated-preference methods, patient reported outcomes, and shared decision making. Advances in regulatory science, patient-focused drug development, patient-centered benefit-risk and health technology assessment will also be considered. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in The Patient may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances. All manuscripts are subject to peer review by international experts.