Poulos Christine, Wakeford Craig, Kinter Elizabeth, Mange Brennan, Schenk Thomas, Jhaveri Mehul
RTI Health Solutions, USA.
Biogen, USA.
Mult Scler J Exp Transl Clin. 2020 Mar 8;6(1):2055217320910778. doi: 10.1177/2055217320910778. eCollection 2020 Jan-Mar.
To assess heterogeneity in patient and physician preferences for multiple sclerosis treatment features and outcomes via a discrete-choice experiment.
Patients with self-reported multiple sclerosis and treating physicians participated in an online discrete-choice experiment. Patients, each considering a better or worse reference condition, and physicians, each considering two patient profiles, chose between hypothetical treatment profiles defined by seven attributes with varying levels: years until disability progression, number of relapses in the decade, mode of administration, dosing frequency, and risks of mild, moderate, and severe side effects. Latent class analysis was used to measure respondent preferences and identify potential subgroups with distinct preferences.
Distinct treatment preferences emerged among subgroups of patients ( = 301) and physicians ( = 308). Patients in class 1 (43% of sample) were most concerned about side effects; chief concerns of class 2 patients (57%) were delaying disability progression and avoiding severe side-effect risks. The most important attributes for physicians (by class) were delaying disability (class 1, 45%), avoiding severe side-effect risks and (class 2, 33%), and avoiding all side-effect risks (class 3, 22%).
Patients and physicians have diverse preferences for multiple sclerosis treatments, reflecting heterogeneity in the disease course and available therapies and the need for shared decision making.
通过离散选择实验评估患者和医生对多发性硬化症治疗特征及结果的偏好异质性。
自我报告患有多发性硬化症的患者及治疗医生参与了一项在线离散选择实验。患者各自考虑一种较好或较差的参照情况，医生各自考虑两种患者概况，在由七个具有不同水平的属性所定义的假设治疗概况中进行选择，这些属性包括：至残疾进展的年限、十年内复发次数、给药方式、给药频率以及轻度、中度和重度副作用风险。采用潜在类别分析来衡量受访者的偏好，并识别具有不同偏好的潜在亚组。
在患者亚组（n = 301）和医生亚组（n = 308）中出现了不同的治疗偏好。第1类患者（占样本的43%）最关注副作用；第2类患者（占57%）主要关注延缓残疾进展和避免严重副作用风险。对医生而言（按类别），最重要的属性分别是延缓残疾（第1类，45%）、避免严重副作用风险（第2类，33%）以及避免所有副作用风险（第3类，22%）。
患者和医生对多发性硬化症治疗有不同的偏好，这反映了疾病病程和可用疗法的异质性以及共同决策的必要性。
