title: Patient weighting of osteoporosis medication attributes across racial and ethnic groups: a study of osteoporosis medication preferences using conjoint analysis.
abstract: We studied the ranking of osteoporosis (OP) medication attributes in a convenience sample of four different racial/ethnic groups in the United States. Our study showed that postmenopausal women differ in the ranking of OP medication attributes based on age, educational level, income, and prior fracture history.
  
  
  BACKGROUND
  Decision making about OP medication-related behavior relies heavily on patient preferences about specific medication attributes. Patients may decide to initiate, change, or stop therapies based on ranking of perceived attributes of the therapy and their personal attitudes toward those attributes. We used MaxDiff, a form of conjoint analysis (Ryan and Farrar 2000), to explore patient weighting of attributes across four racial/ethnic groups at two sites in the United States and defined four critical attributes that influence such decisions (safety, efficacy, cost, and convenience) from qualitative interviews.
  
  
  METHODS
  We recruited a sample of 367 Postmenopausal (PM) women at risk of OP fractures from four racial/ethnic groups: Caucasian (n = 100), African American (n = 100), Asian American (n = 82), and Hispanic American (n = 85). Respondents completed a laptop-based questionnaire that included demographic items, several short scales on medical care preference and OP patient perceptions, and a MaxDiff procedure that determines comparative ranking of attributes either as least important or most important to their decisions.
  
  
  RESULTS
  MaxDiff analyses were done to evaluate the relative weight of specific statements for each participant and to determine whether racial/ethnic groups differed across dimensions. Overall, participants in all four groups rated efficacy > safety > cost > convenience.
  
  
  CONCLUSIONS
  Although there were no significant differences among the racial/ethnic groups on overall ranking of attributes, subgroup analyses revealed significant impact of age, education, income, and prior fracture on these decisions. The findings from this study suggest that postmenopausal women differ in their ranking of OP medication attributes, and healthcare providers must account for personal preferences in their communication about and selection of OP medications.
authors.affiliation: Cedars-Sinai Medical Center, Los Angeles, CA, USA. stuarts@omcresearch.org
authors.forename: S
authors.initials: S
authors.lastname: Silverman
authors.forename: A
authors.initials: A
authors.lastname: Calderon
authors.forename: K
authors.initials: K
authors.lastname: Kaw
authors.forename: T B
authors.initials: TB
authors.lastname: Childers
authors.forename: B A
authors.initials: BA
authors.lastname: Stafford
authors.forename: W
authors.initials: W
authors.lastname: Brynildsen
authors.forename: A
authors.initials: A
authors.lastname: Focil
authors.forename: M
authors.initials: M
authors.lastname: Koenig
authors.forename: D T
authors.initials: DT
authors.lastname: Gold
mesh_terms: D001741:Black or African American / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000523:psychology; D001294:Attitude to Health; D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006304:Health Status; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis / Q000188:drug therapy* / Q000208:ethnology; D058866:Osteoporotic Fractures / Q000208:ethnology / Q000517:prevention & control; D057240:Patient Preference / Q000208:ethnology*; D011594:Psychometrics; D036301:Qualitative Research; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000523:psychology
chemical_list: D050071:Bone Density Conservation Agents