Alan B Ettinger1, John A Carter2, Krithika Rajagopalan3. 1. Safe Passage EEG Services, 915 Broadway, Suite 1200, New York, NY 10010, United States. Electronic address: aettinge@safepassagehealth.com. 2. EPI-Q, Inc., 1315 W 22nd St, Suite 410, Oak Brook, IL 60523, United States. Electronic address: john.carter@epi-q.com. 3. Sunovion Pharmaceuticals Inc., 84 Waterford Drive, Marlborough, MA, 01752, United States. Electronic address: krithika.Rajagopalan@sunovion.com.
Abstract
OBJECTIVE: This assessment was conducted to quantify and compare patient and neurologist preferences regarding antiepileptic drug (AED) attributes for treating epilepsy. METHODS: Patients with epilepsy (≥18years, treated with AEDs) and neurologists were recruited from nationally representative US panels to complete an online survey that included a discrete choice experiment (DCE). Participants chose between two hypothetical AEDs, characterized by six attributes in the DCE, which included 1) level of seizure control/reduction; 2) dosing frequency, 3) diminished coordination and balance, 4) psychiatric issues, 5) diminished energy level, and 6) dietary restrictions. The Sawtooth Software Choice-Based Conjoint (CBC) System for CBC Analysis was used to estimate treatment attribute ranking and weighting. RESULTS: Of the 720 respondents (518 patients and 202 neurologists), both patients and neurologists ranked seizure control as the most important attribute (rank 1) and dietary restrictions as the least important attribute (rank 6). However, seizure control had a significantly greater weighting in neurologists' decision-making than among patients (45% vs 32%, p<0.005). On the other hand, patients considered the risks of psychiatric adverse effects (19% vs 15%), diminished coordination and balance (16% vs 10%), and fatigue or diminished energy (13% vs 11%) as significantly more important (p<0.05) than did neurologists. CONCLUSION: Patients and neurologists had similar preference ranking order, with seizure reduction being ranked the most important attribute. However, neurologist treatment preferences were significantly more influenced by seizure reduction while patient preferences were significantly more influenced by adverse effects that may impact their quality of life. Understanding how patient and neurologist perspectives differ should encourage dialog to communicate the potential risks and benefits of AED therapy and assist in the shared decision-making process.
OBJECTIVE: This assessment was conducted to quantify and compare patient and neurologist preferences regarding antiepileptic drug (AED) attributes for treating epilepsy. METHODS:Patients with epilepsy (≥18years, treated with AEDs) and neurologists were recruited from nationally representative US panels to complete an online survey that included a discrete choice experiment (DCE). Participants chose between two hypothetical AEDs, characterized by six attributes in the DCE, which included 1) level of seizure control/reduction; 2) dosing frequency, 3) diminished coordination and balance, 4) psychiatric issues, 5) diminished energy level, and 6) dietary restrictions. The Sawtooth Software Choice-Based Conjoint (CBC) System for CBC Analysis was used to estimate treatment attribute ranking and weighting. RESULTS: Of the 720 respondents (518 patients and 202 neurologists), both patients and neurologists ranked seizure control as the most important attribute (rank 1) and dietary restrictions as the least important attribute (rank 6). However, seizure control had a significantly greater weighting in neurologists' decision-making than among patients (45% vs 32%, p<0.005). On the other hand, patients considered the risks of psychiatric adverse effects (19% vs 15%), diminished coordination and balance (16% vs 10%), and fatigue or diminished energy (13% vs 11%) as significantly more important (p<0.05) than did neurologists. CONCLUSION:Patients and neurologists had similar preference ranking order, with seizure reduction being ranked the most important attribute. However, neurologist treatment preferences were significantly more influenced by seizure reduction while patient preferences were significantly more influenced by adverse effects that may impact their quality of life. Understanding how patient and neurologist perspectives differ should encourage dialog to communicate the potential risks and benefits of AED therapy and assist in the shared decision-making process.
Authors: Sara Simblett; Mark Pennington; Matthew Quaife; Evangelia Theochari; Patrick Burke; Giampaolo Brichetto; Julie Devonshire; Simon Lees; Ann Little; Angie Pullen; Amanda Stoneman; Sarah Thorpe; Janice Weyer; Ashley Polhemus; Jan Novak; Erin Dawe-Lane; Daniel Morris; Magano Mutepua; Clarissa Odoi; Emma Wilson; Til Wykes Journal: JMIR Form Res Date: 2022-05-23
Authors: Heidi M Munger Clary; Rachel D Croxton; Beverly M Snively; Gretchen A Brenes; James Lovato; Fatemeh Sadeghifar; James Kimball; Cormac O'Donovan; Kelly Conner; Esther Kim; Jonathan Allan; Pamela Duncan Journal: Epilepsy Behav Date: 2020-11-24 Impact factor: 2.937
Authors: Emily A F Holmes; Catrin Plumpton; Gus A Baker; Ann Jacoby; Adele Ring; Paula Williamson; Anthony Marson; Dyfrig A Hughes Journal: Clin Pharmacol Ther Date: 2018-10-25 Impact factor: 6.875