Caylib Durand1,2, Maysoon Eldoma1,2, Deborah A Marshall1,2, Nick Bansback1,2, Glen S Hazlewood3,4. 1. From the Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta; Arthritis Research Canada; Centre for Health Evaluation and Outcome Sciences, Providence Health Care, St. Paul's Hospital, Vancouver, British Columbia, Canada. 2. C. Durand, MD, PhD, FRCP(C), Rheumatology Fellow, University of Calgary; M. Eldoma, MD, FRCP(C), Rheumatology Fellow, University of Calgary; D.A. Marshall, Professor of Medicine, University of Calgary; N. Bansback, Associate Professor, University of British Columbia; G.S. Hazlewood, MD, PhD, FRCP(C), Assistant Professor, University of Calgary. 3. From the Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta; Arthritis Research Canada; Centre for Health Evaluation and Outcome Sciences, Providence Health Care, St. Paul's Hospital, Vancouver, British Columbia, Canada. gshazlew@ucalgary.ca. 4. C. Durand, MD, PhD, FRCP(C), Rheumatology Fellow, University of Calgary; M. Eldoma, MD, FRCP(C), Rheumatology Fellow, University of Calgary; D.A. Marshall, Professor of Medicine, University of Calgary; N. Bansback, Associate Professor, University of British Columbia; G.S. Hazlewood, MD, PhD, FRCP(C), Assistant Professor, University of Calgary. gshazlew@ucalgary.ca.
Abstract
OBJECTIVE: To summarize patients' preferences for disease-modifying antirheumatic drug (DMARD) therapy in rheumatoid arthritis (RA). METHODS: We conducted a systematic review to identify English-language studies of adult patients with RA that measured patients' preferences for DMARD or health states and treatment outcomes relevant to DMARD decisions. Study quality was assessed using a published quality assessment tool. Data on the importance of treatment attributes and associations with patient characteristics were summarized across studies. RESULTS: From 7951 abstracts, we included 36 studies from a variety of countries. Most studies were in patients with established RA and were rated as medium- (n = 19) or high-quality (n = 12). The methods to elicit preferences varied, with the most common being discrete choice experiment (DCE; n = 13). Despite the heterogeneity of attributes in DCE studies, treatment benefits (disease improvement) were usually more important than both non-serious (6 of 8 studies) and serious adverse events (5 of 8), and route of administration (7 of 9). Among the non-DCE studies, some found that patients placed high importance on treatment benefits, while others (in patients with established RA) found that patients were quite risk averse. Subcutaneous therapy was often but not always preferred over intravenous therapy. Patient preferences were variable and commonly associated with the sociodemographic characteristics. CONCLUSION: Overall, the results showed that many patients place a high value on treatment benefits over other treatment attributes, including serious or minor side effects, cost, or route of administration. The variability in patient preferences highlights the need to individualize treatment choices in RA.
OBJECTIVE: To summarize patients' preferences for disease-modifying antirheumatic drug (DMARD) therapy in rheumatoid arthritis (RA). METHODS: We conducted a systematic review to identify English-language studies of adult patients with RA that measured patients' preferences for DMARD or health states and treatment outcomes relevant to DMARD decisions. Study quality was assessed using a published quality assessment tool. Data on the importance of treatment attributes and associations with patient characteristics were summarized across studies. RESULTS: From 7951 abstracts, we included 36 studies from a variety of countries. Most studies were in patients with established RA and were rated as medium- (n = 19) or high-quality (n = 12). The methods to elicit preferences varied, with the most common being discrete choice experiment (DCE; n = 13). Despite the heterogeneity of attributes in DCE studies, treatment benefits (disease improvement) were usually more important than both non-serious (6 of 8 studies) and serious adverse events (5 of 8), and route of administration (7 of 9). Among the non-DCE studies, some found that patients placed high importance on treatment benefits, while others (in patients with established RA) found that patients were quite risk averse. Subcutaneous therapy was often but not always preferred over intravenous therapy. Patient preferences were variable and commonly associated with the sociodemographic characteristics. CONCLUSION: Overall, the results showed that many patients place a high value on treatment benefits over other treatment attributes, including serious or minor side effects, cost, or route of administration. The variability in patient preferences highlights the need to individualize treatment choices in RA.
Authors: Peter C Taylor; Codrina Ancuta; Orsolya Nagy; María C de la Vega; Andrey Gordeev; Radka Janková; Umut Kalyoncu; Ivan Lagunes-Galindo; Jadranka Morović-Vergles; Mariana Peixoto G U E Silva de Souza; Bernadette Rojkovich; Prodromos Sidiropoulos; Atsushi Kawakami Journal: Patient Prefer Adherence Date: 2021-02-17 Impact factor: 2.711
Authors: Gyanendra Pokharel; Rob Deardon; Sindhu R Johnson; George Tomlinson; Pauline M Hull; Glen S Hazlewood Journal: Rheumatology (Oxford) Date: 2021-08-02 Impact factor: 7.580
Authors: Glen S Hazlewood; Deborah A Marshall; Claire E H Barber; Linda C Li; Cheryl Barnabe; Vivian Bykerk; Peter Tugwell; Pauline M Hull; Nick Bansback Journal: Patient Prefer Adherence Date: 2020-05-18 Impact factor: 2.711