title: A discrete-choice experiment to quantify patient preferences for frequency of glucagon-like peptide-1 receptor agonist injections in the treatment of type 2 diabetes.
abstract: OBJECTIVE
  Understanding patients' preferences for attributes of injectable antihyperglycemic regimens may improve patient satisfaction and medication adherence. Our objective was to quantify the preferences of patients with type 2 diabetes mellitus (T2DM) for reducing the frequency of glucagon-like peptide-1 receptor agonist injections from once daily to once weekly.
  
  
  METHODS
  A total of 643 respondents with a self-reported physician diagnosis of type 2 diabetes completed a web-based discrete-choice experiment survey. The sample included four prespecified subgroups: currently using exenatide once weekly (n = 150), liraglutide once daily (n = 153), insulin (but not exenatide once weekly or liraglutide) (n = 156), and no injectable treatment (n = 184). Device attributes included type of injection device, needle size and pain, injection frequency, refrigeration, and injection-site reactions. Random-parameters logit was used to estimate the relative impact of device attributes on treatment choice for each subgroup.
  
  
  RESULTS
  In all subgroups, changing injection frequency from daily to weekly (independent of the effect of injection frequency on preferences for other attributes) was the most important predictor of treatment choice. Switching from a longer and thicker needle to a shorter and thinner needle and eliminating injection-site reactions were also statistically significant predictors of device choice (P < 0.05). Exenatide once weekly users and those not currently using injections were more likely to choose a treatment with characteristics similar to exenatide once weekly.
  
  
  CONCLUSIONS
  The treatment attribute most important to patients choosing among hypothetical injectable treatments for T2DM was injection frequency: patients preferred weekly over daily injections.
  
  
  CONCLUSIONS
  The primary limitations of this study are that it included only a limited number of attributes that may not reflect the full complexity of patient choices, diagnosis was self-reported, and patients were recruited from an Internet panel and may not be representative of the T2DM patient population.
authors.affiliation: a a RTI Health Solutions, Research Triangle Park , NC , USA.
authors.forename: A Brett
authors.initials: AB
authors.lastname: Hauber
authors.affiliation: b b AstraZeneca, Fort Washington , PA , USA.
authors.forename: Hiep
authors.initials: H
authors.lastname: Nguyen
authors.affiliation: a a RTI Health Solutions, Research Triangle Park , NC , USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Posner
authors.affiliation: c c Johnson and Johnson , New Brunswick , NJ , USA (was with AstraZeneca at the time this study was developed).
authors.forename: Iftekhar
authors.initials: I
authors.lastname: Kalsekar
authors.affiliation: b b AstraZeneca, Fort Washington , PA , USA.
authors.forename: James
authors.initials: J
authors.lastname: Ruggles
mesh_terms: D000328:Adult; D000368:Aged; D002755:Choice Behavior; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004334:Drug Administration Schedule; D000077270:Exenatide; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007267:Injections; D007328:Insulin / Q000627:therapeutic use; D000069450:Liraglutide / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D010455:Peptides / Q000008:administration & dosage*; D014688:Venoms / Q000008:administration & dosage*; D000097789:Glucagon-Like Peptide-1 Receptor Agonists
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D010455:Peptides; D014688:Venoms; D000069450:Liraglutide; D000077270:Exenatide; D000097789:Glucagon-Like Peptide-1 Receptor Agonists
keywords: Conjoint analysis; Discrete-choice experiment; GLP-1 receptor agonist; Injection; Preference; Type 2 diabetes mellitus