Patient preferences for characteristics of antiretroviral therapies: results from five European countries.
BACKGROUND
Patient preference to antiretroviral therapy (ART) characteristics should be a key consideration in treatment decisions. ART options exist for people living with HIV (PLWH), however concerns remain related to PLWH satisfaction with current ARTs. The current study examines patient preferences and the strength of preferences for treatment characteristics associated with ART.


METHODS
Patients' preferences to ART were explored using a discrete choice experiment (DCE). Seven defined treatment characteristics (each with three categories) were identified from a literature review, input from experts, PLWH and physicians. A total of 1582 PLWH from France, Germany, Spain, Italy and the UK were recruited for the study. An adjusted odds ratio <1 signified lower odds of selecting a treatment with this characteristic category, compared to the reference category, independently of other characteristics.


RESULTS
The patient preference analyses showed that participants preferred treatments with a rapid reduction in viral load (OR=0.78; 95% CI 0.74-0.81) and CD4 count (OR=0.86; 95% CI=0.82-0.89). Participants had a strong preference for avoiding diarrhoea (Odds ratio, OR=0.36 95% CI=0.33-0.38) and long term health problems (OR=0.30, 95% CI=0.28-0.32). Convenience related issues related to restrictions on taking drugs because of food or drug interactions were important to avoid (OR=0.80, 95% CI=0.76-0.83 and OR=0.72 95% CI=0.69-0.76 respectively). Participants also had a strong preference to avoid drugs which limited the effectiveness of future treatments (OR=0.70, 95% CI=0.67-0.73).


CONCLUSIONS
Avoidance of diarrhoea and long-term complications were the most important drivers of patient choice. This study, from a large sample of European patients, demonstrates the importance to patients when different aspects of HIV treatment are considered simultaneously.
HIV and Sexual Health, Chelsea & Westminster, London, UK.
Brian
B
Gazzard
Health Economics, ICON plc, Oxford, UK.
Shehzad
S
Ali
Economics, IGM Institute of Management, Neubrandenburg, Germany.
Axel
A
Muhlbacher
Medical Affairs, ViiV Healthcare, Munich, Germany.
Neda
N
Ghafouri
Antiviral Therapy Unit, Bergamo, Italy.
Franco
F
Maggiolo
Patient Reported Outcomes, ICON plc, Oxford, UK.
Catherine
C
Golics
Vaccine and Immunotherapy Research, IRCCS, San Raffaele, Italy.
Silvia
S
Nozza
SEISIDA, Madrid, Spain.
Maria Jose
MJ
Fuster
H. Conxo, S de Compostela, Spain.
Antonio
A
Antela
Biostatistics and Clinical Research, Faculte de Medecine de Caen, Caen, France.
Jean Jacques
JJ
Parienti
Medical Affairs, ViiV Healthcare, Singapore, Singapore.
Nathalie
N
Dang
Immunology and Hematology, CHU Sainte - Marguerite, Marseille, France.
Sylvie Ronot
SR
Bregigeon
Medical Affairs, ViiV Healthcare, London, UK.
Andrew
A
Benzie
Health Outcomes, ViiV Healthcare, London, UK.
Miranda
M
Murray