[Patients' preferences in the medicamentous treatment of diabetes mellitus type 2: A systematic classification and meta-comparison of patient preference studies].

OBJECTIVE

Diabetes Mellitus is one of the most expensive common diseases. Because of the great socio-economic importance of this indication, it seems necessary to consider the expectations and needs of all patients with regard to treatment characteristics. To evaluate patient preferences stated-preference methods are increasingly used. The aim was to analyze and compare the available evidence from patient preference studies regarding the treatment characteristics and to display which target criteria in the medicinal treatment of diabetes mellitus type 2 are most important from the patients view.

METHODS

A literature review in PubMed was conducted to identify stated preference studies in the indication of diabetes and show which properties of a treatment are relevant to the patient's benefit. By means of level difference calculation and a subsequent normalization uniform weights for the attributes of the studies were determined. Based on a final ranking the key criteria according to their value proposition from the perspective of affected populations are demonstrated.

RESULTS

N = 13 studies could be included in the analysis. By calculating the level difference and performing a normalization it was possible to obtain a uniform representation of all attributes of N = 7 studies. The preference studies show that the control of blood sugar, side effects (such as hypoglycemia, nausea and stomach discomfort or weight changes), long-term complications and the mode of administration represent the most common patient-relevant outcomes in diabetes therapy. In five of the 13 DCE studies the blood glucose control achieved the highest ranking within the relative importance score in the treatment of diabetes mellitus. In two studies, the side effects hypoglycemia and weight changes occupied the first rank. Furthermore, in two other studies, the side effects of nausea/upset stomach and in one study the type of application determined as the primary outcome measure.

CONCLUSIONS

The use of stated preference methods in health economics aims to reflect the benefit assessments of therapy features from patient's or expert perspective. So far it is unclear how this evidence is documented in benefit assessment of medical interventions and how the findings will be made available to decision-makers. Based on the findings of this review the evidence of patient preferences in diabetes treatment is synthesized. The results show the relative importance based on a derived ranking score of the used patient-relevant endpoints. The ranking allows the comparison of the results of the identified preference studies.