title: Patient preferences for managing asthma: results from a discrete choice experiment.
abstract: Effective control of asthma requires regular preventive medication. Poor medication adherence suggests that patient preferences for medications may differ from the concerns of the prescribing clinicians. This study investigated patient preferences for preventive medications across symptom control, daily activities, medication side-effects, convenience and costs, using a discrete choice experiment embedded in a randomized clinical trial involving patients with mild-moderate persistent asthma. The present data were collected after patients had received 6 weeks' treatment with one of two drugs. Three choice options were presented, to continue with the current drug, to change to an alternative, hypothetical drug, or to take no preventive medication. Analysis used random parameter multinomial logit. Most respondents chose to continue with their current drug in most choice situations but this tendency differed depending on which medication they had been allocated. Respondents valued their ability to participate in usual daily activities and sport, preferred minimal symptoms, and were less likely to choose drugs with side-effects. Cost was also significant, but other convenience attributes were not. Demographic characteristics did not improve the model fit. This study illustrates how discrete choice experiments may be embedded in a clinical trial to provide insights into patient preferences.
authors.affiliation: Centre for Health Economics Research and Evaluation, University of Technology Sydney, Australia. Madeleine.king@chere.uts.edu.au
authors.forename: Madeleine T
authors.initials: MT
authors.lastname: King
authors.forename: Jane
authors.initials: J
authors.lastname: Hall
authors.forename: Emily
authors.initials: E
authors.lastname: Lancsar
authors.forename: Denzil
authors.initials: D
authors.lastname: Fiebig
authors.forename: Ishrat
authors.initials: I
authors.lastname: Hossain
authors.forename: Jordan
authors.initials: J
authors.lastname: Louviere
authors.forename: Helen K
authors.initials: HK
authors.lastname: Reddel
authors.forename: Christine R
authors.initials: CR
authors.lastname: Jenkins
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D001315:Australia; D002755:Choice Behavior; D004333:Drug Administration Routes; D004334:Drug Administration Schedule; D005252:Fees, Pharmaceutical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D017060:Patient Satisfaction; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D018927:Anti-Asthmatic Agents