Lynd Larry D, Traboulsee Anthony, Marra Carlo A, Mittmann Nicole, Evans Charity, Li Kathy H, Carter Melanie, Hategekimana Celestin
Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC, Canada V6T 1Z3.
Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Ther Adv Neurol Disord. 2016 Jul;9(4):287-96. doi: 10.1177/1756285616648060. Epub 2016 May 15.
With recent developments in drug therapy for multiple sclerosis (MS), new treatment options have become available presenting patients with complex treatment decisions.
The objective of this study was to elicit patients' preferences for different attributes of MS drug therapy.
A representative sample of patients with MS across Canada (n=189) participated in a best-worst scaling study to quantify preferences for different attributes of MS drug therapy, including delaying progression, improving symptoms, preventing relapse, minor side effects, rare but serious adverse events (SAEs), and route of administration. Conditional logit models were fitted to estimate the relative importance of each attribute in influencing patients' preferences.
A latent-class analysis revealed heterogeneity of preferences across respondents, with preferences differing across five classes. The most important attributes of drug therapy were the avoidance of SAEs for three classes and the improvement of symptoms for two other classes. Only a smaller group of patients demonstrated a specific preference for avoiding SAEs, and route of administration.
This study shows that preferences for drug therapy among patients with MS are different, some of which can be explained by experiences with their disease and treatment. These findings can help to inform the focus of interactions that healthcare practitioners have with patients with MS, as well as further drug development.
随着多发性硬化症（MS）药物治疗的最新进展，出现了新的治疗选择，这给患者带来了复杂的治疗决策。
本研究的目的是了解患者对MS药物治疗不同属性的偏好。
加拿大各地的189名MS患者代表性样本参与了一项最佳-最差尺度研究，以量化对MS药物治疗不同属性的偏好，包括延缓疾病进展、改善症状、预防复发、轻微副作用、罕见但严重的不良事件（SAEs）以及给药途径。采用条件logit模型估计各属性在影响患者偏好方面的相对重要性。
潜在类别分析揭示了受访者偏好的异质性，在五个类别中偏好各不相同。药物治疗最重要的属性，在三个类别中是避免SAEs，在另外两个类别中是改善症状。只有一小部分患者表现出对避免SAEs和给药途径的特定偏好。
本研究表明，MS患者对药物治疗的偏好各不相同，其中一些可以通过他们的疾病和治疗经历来解释。这些发现有助于为医护人员与MS患者互动的重点以及进一步的药物开发提供信息。
