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      Patient Preference and Adherence (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on the growing importance of patient preference and adherence throughout the therapeutic process. Sign up for email alerts here.

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      Evaluating preferences for profiles of glucagon-like peptide-1 receptor agonists among injection-naive type 2 diabetes patients in Japan

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          Abstract

          Objective

          The objective of this study was to use a discrete choice experiment (DCE) to estimate patients’ preferences for the treatment features, safety, and efficacy of two specific glucagon-like peptide-1 receptor agonists, dulaglutide and liraglutide, among patients with type 2 diabetes mellitus (T2DM) in Japan.

          Methods

          In Japan, patients with self-reported T2DM and naive to treatment with self-injectable medications were administered a DCE through an in-person interview. The DCE examined the following six attributes of T2DM treatment, each described by two levels: “dosing frequency”, “hemoglobin A1c change”, “weight change”, “type of delivery system”, “frequency of nausea”, and “frequency of hypoglycemia”. Part-worth utilities were estimated using logit models and were used to calculate the relative importance (RI) of each attribute. A chi-square test was used to determine the differences in preferences for the dulaglutide versus liraglutide profiles.

          Results

          The final evaluable sample consisted of 182 participants (mean age: 58.9 [standard deviation =10.0] years; 64.3% male; mean body mass index: 26.1 [standard deviation =5.0] kg/m 2). The RI values for the attributes in rank order were dosing frequency (44.1%), type of delivery system (26.3%), frequency of nausea (15.1%), frequency of hypoglycemia (7.4%), weight change (6.2%), and hemoglobin A1c change (1.0%). Significantly more participants preferred the dulaglutide profile (94.5%) compared to the liraglutide profile (5.5%; P<0.0001).

          Conclusion

          This study elicited the preferences of Japanese T2DM patients for attributes and levels representing the actual characteristics of two existing glucagon-like peptide-1 receptor agonists. In this comparison, dosing frequency and type of delivery system were the two most important characteristics, accounting for >70% of the RI. These findings are similar to those of a previous UK study, providing information about patients’ preferences that may be informative for patient–clinician treatment discussions.

          Most cited references22

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          Barriers to diabetes management: patient and provider factors.

          Despite significant advances in diagnosis and treatment, the persistence of inadequate metabolic control continues. Poor glycemic control may be reflected by both the failure of diabetes self-management by patients as well as inadequate intervention strategies by clinicians. The purpose of this systematic review is to summarize existing knowledge regarding various barriers of diabetes management from the perspectives of both patients and clinicians. A search of PubMed, CINAHL, ERIC, and PsycINFO identified 1454 articles in English published between 1990 and 2009, addressing type 2 diabetes, patient's barriers, clinician's barriers, and self-management. Patients' adherence, attitude, beliefs, and knowledge about diabetes may affect diabetes self-management. Culture and language capabilities influence the patient's health beliefs, attitudes, health literacy, thereby affecting diabetes self-management. Other influential factors include the patient's financial resources, co-morbidities, and social support. Clinician's attitude, beliefs and knowledge about diabetes also influence diabetes management. Clinicians may further influence the patient's perception through effective communication skills and by having a well-integrated health care system. Identifying barriers to diabetes management is necessary to improve the quality of diabetes care, including the improvement of metabolic control, and diabetes self-management. Further research that considers these barriers is necessary for developing interventions for individuals with type 2 diabetes. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
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            Conjoint Analysis Applications in Health - How are Studies being Designed and Reported?: An Update on Current Practice in the Published Literature between 2005 and 2008.

            Despite the increased popularity of conjoint analysis in health outcomes research, little is known about what specific methods are being used for the design and reporting of these studies. This variation in method type and reporting quality sometimes makes it difficult to assess substantive findings. This review identifies and describes recent applications of conjoint analysis based on a systematic review of conjoint analysis in the health literature. We focus on significant unanswered questions for which there is neither compelling empirical evidence nor agreement among researchers.We searched multiple electronic databases to identify English-language articles of conjoint analysis applications in human health studies published since 2005 through to July 2008. Two independent reviewers completed the detailed data extraction, including descriptive information, methodological details on survey type, experimental design, survey format, attributes and levels, sample size, number of conjoint scenarios per respondent, and analysis methods. Review articles and methods studies were excluded. The detailed extraction form was piloted to identify key elements to be included in the database using a standardized taxonomy.We identified 79 conjoint analysis articles that met the inclusion criteria. The number of applied studies increased substantially over time in a broad range of clinical applications, cancer being the most frequent. Most used a discrete-choice survey format (71%), with the number of attributes ranging from 3 to 16. Most surveys included 6 attributes, and 73% presented 7-15 scenarios to each respondent. Sample size varied substantially (minimum = 13, maximum = 1258), with most studies (38%) including between 100 and 300 respondents. Cost was included as an attribute to estimate willingness to pay in approximately 40% of the articles across all years.Conjoint analysis in health has expanded to include a broad range of applications and methodological approaches. Although we found substantial variation in methods, terminology, and presentation of findings, our observations on sample size, the number of attributes, and number of scenarios presented to respondents should be helpful in guiding researchers when planning a new conjoint analysis study in health.
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              GLP-1 receptor agonists: a review of head-to-head clinical studies.

              Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are attractive options for the treatment of type 2 diabetes (T2D) because they effectively lower A1C and weight while having a low risk of hypoglycemia. The GLP-1 RA class has grown in the last decade with several agents available for use in the US and Europe and several more in development. Since the efficacy and tolerability, dosing frequency, administration requirements, and cost may vary between agents within the class, each agent may offer unique advantages and disadvantages. Through a review of phase III clinical programs for exenatide twice daily, exenatide once weekly, liraglutide, albiglutide, lixisenatide, and dulaglutide, eight head-to-head trials have evaluated the safety and efficacy of GLP-1 RA active comparators. The purpose of this review is to provide an analysis of these trials. The GLP-1 RA head-to-head clinical studies have demonstrated that all GLP-1 RA agents are effective therapeutic options at reducing A1C. However, differences exist in terms of magnitude of effect on A1C and weight as well as frequency and severity of adverse effects.
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                Author and article information

                Journal
                Patient Prefer Adherence
                Patient Prefer Adherence
                Patient Preference and Adherence
                Patient preference and adherence
                Dove Medical Press
                1177-889X
                2016
                25 July 2016
                : 10
                : 1337-1348
                Affiliations
                [1 ]Outcomes Research, Evidera, Bethesda, MD
                [2 ]Evidera, Seattle, WA
                [3 ]Global Patient Outcomes and Real World Evidence, Eli Lilly and Company, Indianapolis, IN, USA
                [4 ]Medicines Development Unit Japan, Eli Lilly Japan, Kobe, Japan
                Author notes
                Correspondence: Heather L Gelhorn, Evidera, 7101 Wisconsin Avenue, Suite 1400, Bethesda, MD 20814, USA, Tel +1 303 216 2274, Fax +1 303 271 3665, Email heather.gelhorn@ 123456evidera.com
                Article
                ppa-10-1337
                10.2147/PPA.S109289
                4966566
                27524889
                112c0d58-074c-4a7e-acb3-f541e5afd76e
                © 2016 Gelhorn et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

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                Original Research

                Medicine
                discrete choice experiment,patient’s preference,type 2 diabetes,glp-1 receptor agonists,willingness to inject

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