RTI Health Solutions, Health Preference Assessment, Belfast, UK.
Eli Lilly and Company, Bad Homburg, Germany.
J Dermatolog Treat. 2022 May;33(3):1598-1605. doi: 10.1080/09546634.2020.1869145. Epub 2021 Jan 7.
This study aimed to elicit preferences for psoriasis treatment features and to test for preference heterogeneity across groups of respondents.
A discrete-choice experiment was employed to elicit preferences of patients with plaque psoriasis in multiple countries. The survey instrument included a series of choice questions between three hypothetical treatments, each characterized by varying levels of six attributes (namely, lesion reduction, risk of impairing side effects, time to reach results, mode and frequency of administration, itching reduction, and side effects). Random parameters logit was used to model the data. Results were compared across a total of 18 subgroup sets.
The data analysis from 1,123 respondents showed that, on average, respondents receive more utility gain from higher levels of lesion reduction and lower risks of impairing side effects than changes in other attributes included in the study. Systematic differences were detected for 13 sets; the most pronounced differences were observed based on disease severity, nail psoriasis, biologic experience, and quality-of-life scores.
These many sources of preference heterogeneity identified by our analysis suggest that to improve patient satisfaction and, probably, adherence and persistence, clinicians should discuss options with patients when prescribing their treatment.
本研究旨在了解银屑病治疗特征的偏好，并检验不同受访者群体间的偏好异质性。
采用离散选择实验，在多个国家调查斑块型银屑病患者的偏好。调查工具包括三组假设治疗方案之间的一系列选择题，每组方案的特征是六个属性（即皮损改善、不良反应风险、达到疗效的时间、给药方式和频率、瘙痒减轻、不良反应）的不同水平。采用随机参数对数模型对数据进行建模。结果在总共 18 个亚组中进行了比较。
对 1123 名受访者的数据分析表明，平均而言，与研究中包含的其他属性变化相比，受访者从更高水平的皮损改善和更低的不良反应风险中获得更多的效用增益。在 13 个组中检测到系统差异；最显著的差异是基于疾病严重程度、指甲银屑病、生物制剂治疗经验和生活质量评分。
我们的分析确定了许多偏好异质性来源，这表明为了提高患者满意度，可能还包括提高患者的依从性和持久性，临床医生在为患者开处方时应与患者讨论治疗方案。
