A discrete-choice experiment to assess patients' preferences for osteoarthritis treatment: An ESCEO working group.
Hiligsmann M., Dennison E., Beaudart C., Herrero-Beaumont G., Branco J., Bruyère O., Conaghan PG., Cooper C., Al-Daghri N., Jiwa F., Lems W., Pinto D., Rizzoli R., Thomas T., Uebelhart D., Veronese N., Reginster J-Y.
OBJECTIVE: To evaluate the preferences of patients with osteoarthritis for treatment. METHODS: A discrete-choice experiment was conducted among adult OA patients who were presented with 12 choice sets of two treatment options and asked in each to select the treatment they would prefer. Based on literature reviews, expert consultation, patient survey and expert meeting, treatment options were characterized by seven attributes: improvement in pain, improvement in walking, ability to manage domestic activities, ability to manage social activities, improvement in overall energy and well-being, risk of moderate/severe side effects and impact on disease progression. Random parameters logit model was used to estimate patients' preferences and a latent class model was conducted to explore preferences classes. RESULTS: 253 OA patients from seven European countries were included (74% women; mean age 71.3 years). For all seven treatment attributes, significant differences were observed between levels. Given the range of levels of each attribute, the most important treatment attribute in this group was impact on disease progression (29.5%) followed by walking improvement (17.1%) and pain improvement (16.3%). The latent class model identified two preference classes. In the first class (probability of 56%), patients valued impact of disease progression the most (39%). In the second class, walking improvement and improvement in overall energy and well-being were the most important (23%). CONCLUSION: This study suggests that all seven treatment attributes were important for OA patients. Overall, given the range of levels, the most important outcomes were impact on disease progression and improvement in pain and walking.