Evaluating Patient Preferences of Maintenance Therapy for the Treatment of Chronic Obstructive Pulmonary Disease: A Discrete Choice Experiment in the UK, USA and Germany

Abstract

Introduction

With increasing availability of different treatments for chronic obstructive pulmonary disease (COPD), we sought to understand patient preferences for COPD treatment in the UK, USA, and Germany using a discrete choice experiment (DCE).

Methods

Qualitative research identified six attributes associated with COPD maintenance treatments: ease of inhaler use, exacerbation frequency, frequency of inhaler use, number of different inhalers used, side effect frequency, and out-of-pocket costs. A DCE using these attributes, with three levels each, was designed and tested through cognitive interviews and piloting. It comprised 18 choice sets, selected using a D-efficient experimental design. Demographics and disease history were collected and the final DCE survey was completed online by participants recruited from panels in the UK, USA and Germany. Responses were analyzed using mixed logit models, with results expressed as odds ratios (ORs).

Results

Overall, 450 participants (150 per country) completed the DCE; most (UK and Germany, 97.3%; USA, 98.0%) were included in the final analysis. Based on relative attribute importance, avoidance of side effects was found to be most important (UK: OR 11.65; USA: OR 7.17; Germany: OR 11.45; all p<0.0001), followed by the likelihood of fewer exacerbations (UK: OR 2.22; USA: OR 1.63; Germany: OR 2.54; all p<0.0001) and increased ease of use (UK: OR 1.84; USA: OR 1.84; Germany: OR 1.60; all p<0.0001). Number of inhalers, out-of-pocket costs, and frequency of inhaler use were found to be less important. Preferences were relatively consistent across the three countries. All participants required a reduction in exacerbations to accept more frequent inhaler use or use of more inhalers.

Conclusion

When selecting COPD treatment, individuals assigned the highest value to the avoidance of side effects, experiencing fewer exacerbations, and ease of inhaler use. Ensuring that patients’ preferences are considered may encourage treatment compliance.

Journal

Journal ID (nlm-ta): Int J Chron Obstruct Pulmon Dis

Journal ID (iso-abbrev): Int J Chron Obstruct Pulmon Dis

Journal ID (publisher-id): COPD

Journal ID (pmc): copd

Title: International Journal of Chronic Obstructive Pulmonary Disease

Publisher: Dove

ISSN (Print): 1176-9106

ISSN (Electronic): 1178-2005

Publication date (Electronic): 18 March 2020

Publication date Collection: 2020

Volume: 15

Pages: 595-604

Affiliations

[1 ]Patient Centred Outcomes, ICON plc ., London, UK

[2 ]Value Evidence and Outcomes, GlaxoSmithKline plc ., Brentford, UK

[3 ]Value Evidence and Outcomes, GlaxoSmithKline plc ., Uxbridge, UK

[4 ]Patient Centred Outcomes, ICON plc ., Gaithersburg, MD, USA

[5 ]Patient Centred Outcomes, ICON plc ., Abingdon, UK

[6 ]Respiratory Therapy Area, GlaxoSmithKline plc ., Brentford, UK

[7 ]Value Evidence and Outcomes, GlaxoSmithKline plc ., Collegeville, PA, USA

[8 ]Department of Health Research Methods, Evidence and Impact, McMaster University , Hamilton, ON, Canada

Author notes

Correspondence: Afisi S Ismaila Value Evidence and Outcomes, GlaxoSmithKline plc ., 1250 South Collegeville Road, Collegeville, PA19426-0989, USATel [phone] Email [e-mail]

Article

Publisher ID: 221980

DOI: 10.2147/COPD.S221980

PMC ID: 7094150

Copyright statement: © 2020 Lewis et al.

License:

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Page count

Figures: 3, Tables: 4, References: 20, Pages: 10

Funding

The study was funded by GlaxoSmithKline plc. (clinicaltrials.gov NCT03046069; GlaxoSmithKline plc. study CTT206455). Editorial support (in the form of writing assistance, collating author comments, assembling tables/figures, grammatical editing, and referencing) was provided by Molly Macpherson, BSc, of Gardiner–Caldwell Communications (Macclesfield, UK), and was funded by GlaxoSmithKline plc. Trade marks are owned by or licensed to their respective owners (the GSK group of companies or AstraZeneca PLC).

Categories

Subject: Original Research