Discrete choice experiments identifying attributes influencing treatment preference in mild asthma

Abstract

<b>Introduction:</b> Knowledge of patient priorities is important to select appropriate treatment. Discrete choice experiment (DCE) methodology involves making trade-offs which indicate patients’ preferences. <b>Aim:</b> To determine the relative importance to participants in the PRACTICAL study, a 12-month open-label RCT of symptom-driven budesonide-formoterol versus regular budesonide plus as-needed terbutaline, of attributes distinguishing these regimens. <b>Methods:</b> Regimen attributes were identified using focus groups. Participants finishing the PRACTICAL study after 26 March 2018 at 6/14 sites completed one of two DCEs based on their stated preference for as-needed combined preventer/reliever therapy or regular preventer and as needed reliever. 1000minds software and the PAPRIKA method were used for the DCEs. <b>Results:</b> The DCEs were completed by 296 of 407 (73%) eligible participants. Figure 1 shows preference weights representing the relative importance of the attributes in the DCEs. Frequency of breathlessness had a stronger influence on choice than risk of flare up, type of regimen or steroid dose. Within each DCE, attribute weights were not affected by the patient’s randomisation group. <b>Conclusions:</b> In these DCEs, participant’s preferences were influenced by several attributes in addition to as-needed versus regular treatment. The relative importance of such attributes should be considered during shared decision-making with patients.