Leslie Wilson1, Aimee Loucks2, Christine Bui3, Greg Gipson3, Lixian Zhong3, Amy Schwartzburg4, Elizabeth Crabtree5, Douglas Goodin6, Emmanuelle Waubant7, Charles McCulloch8. 1. Health Policy and Economics, University of California San Francisco, Departments of Medicine and Pharmacy, 3333 California Street, San Francisco, CA 94143, USA. Electronic address: wilsonL@pharmacy.ucsf.edu. 2. University of California San Francisco, Department of Clinical Pharmacy, 3333 California Street, San Francisco, CA 94143, USA. Electronic address: Aimee.Loucks@gmail.com. 3. University of California San Francisco, Department of Clinical Pharmacy, 3333 California Street, San Francisco, CA 94143, USA. 4. University of California San Francisco, Department of Neurology, 1500 Owens Street, Suite 320, San Francisco, CA 94158, USA. Electronic address: amy.outdoor@ucsfmedctr.org. 5. UCSF Multiple Sclerosis Center, 1500 Owens Street, Suite 320, San Francisco, CA 94158, USA. Electronic address: Liz.Crabtree-Hartman@ucsf.edu. 6. UCSF Multiple Sclerosis Center, 1500 Owens Street, Suite 320, San Francisco, CA 94158, USA. Electronic address: Douglas.Goodin@ucsf.edu. 7. University of California San Francisco, Regional Pediatric MS Center Director, 1500 Owens Street, Suite 320, San Francisco, CA 94158, USA. Electronic address: Emmanuelle.Waubant@ucsf.edu. 8. Division of Biostatistics, University of California San Francisco, Department of Epidemiology and Biostatistics, 185 Berry Street, Suite 5700, Box 0560, San Francisco, CA 94107-1762, USA. Electronic address: chuck@biostat.ucsf.edu.
Abstract
UNLABELLED: Understanding patient preferences facilitates shared decision-making and focuses on patient-centered outcomes. Little is known about relapsing-remitting multiple sclerosis (RRMS) patient preferences for disease modifying therapies (DMTs). We use choice based conjoint (CBC) analysis to calculate patient preferences for risk/benefit trade-offs for hypothetical DMTs. METHODS: Patients with RRMS were surveyed between 2012 and 2013. Our CBC survey mimicked the decision-making process and trade-offs of patients choosing DMTs, based on all possible DMT attributes. Mixed-effects logistic regression analyzed preferences. We estimated maximum acceptable risk trade-offs for various DMT benefits. RESULTS: Severe side-effect risks had the biggest impact on patient preference with a 1% risk, decreasing patient preference five-fold compared to no risk. (OR=0.22, p<0.001). Symptom improvement was the most preferred benefit (OR=3.68, p<0.001), followed by prevention of progression of 10 years (OR=2.4, p<0.001). Daily oral administration had the third highest DMT preference rating (OR=2.08, p<0.001). Patients were willing to accept 0.08% severe risk for a year delayed relapse, and 0.22% for 4 vs 2 year prevented progression. CONCLUSION: We provided patient preferences and risk-benefit trade-offs for attributes of all available DMTs. Evaluation of patient preferences is a key step in shared decision making and may significantly impact early drug initiation and compliance.
UNLABELLED: Understanding patient preferences facilitates shared decision-making and focuses on patient-centered outcomes. Little is known about relapsing-remitting multiple sclerosis (RRMS) patient preferences for disease modifying therapies (DMTs). We use choice based conjoint (CBC) analysis to calculate patient preferences for risk/benefit trade-offs for hypothetical DMTs. METHODS:Patients with RRMS were surveyed between 2012 and 2013. Our CBC survey mimicked the decision-making process and trade-offs of patients choosing DMTs, based on all possible DMT attributes. Mixed-effects logistic regression analyzed preferences. We estimated maximum acceptable risk trade-offs for various DMT benefits. RESULTS: Severe side-effect risks had the biggest impact on patient preference with a 1% risk, decreasing patient preference five-fold compared to no risk. (OR=0.22, p<0.001). Symptom improvement was the most preferred benefit (OR=3.68, p<0.001), followed by prevention of progression of 10 years (OR=2.4, p<0.001). Daily oral administration had the third highest DMT preference rating (OR=2.08, p<0.001). Patients were willing to accept 0.08% severe risk for a year delayed relapse, and 0.22% for 4 vs 2 year prevented progression. CONCLUSION: We provided patient preferences and risk-benefit trade-offs for attributes of all available DMTs. Evaluation of patient preferences is a key step in shared decision making and may significantly impact early drug initiation and compliance.
Authors: Edward J D Webb; David Meads; Ieva Eskyte; Natalie King; Naila Dracup; Jeremy Chataway; Helen L Ford; Joachim Marti; Sue H Pavitt; Klaus Schmierer; Ana Manzano Journal: Patient Date: 2018-08 Impact factor: 3.883
Authors: Marsha N Wittink; Patrick Walsh; Sule Yilmaz; Michael Mendoza; Richard L Street; Benjamin P Chapman; Paul Duberstein Journal: Patient Educ Couns Date: 2017-08-08
Authors: Lindsay A Hampson; Isabel E Allen; Thomas W Gaither; Tracy Lin; Jie Ting; E Charles Osterberg; Leslie Wilson; Benjamin N Breyer Journal: Urology Date: 2016-09-16 Impact factor: 2.649
Authors: 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 Journal: Patient Date: 2020-10 Impact factor: 3.883