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Patient preferences on rheumatoid arthritis second-line treatment: a discrete choice experiment of Swedish patients
Centre for Research Ethics & Bioethics, Department of Public Health and Caring Sciences, Uppsala University, Husargatan 3, Box 564, Uppsala, 752 37, Sweden.ORCID iD: 0000-0002-5865-5590
Centre for Research Ethics & Bioethics, Department of Public Health and Caring Sciences, Uppsala University, Husargatan 3, Box 564, Uppsala, 752 37, Sweden.
Centre for Research Ethics & Bioethics, Department of Public Health and Caring Sciences, Uppsala University, Husargatan 3, Box 564, Uppsala, 752 37, Sweden.
Institute of Inflammation and Ageing, University of Birmingham Research Laboratories, Queen Elizabeth Hospital, Birmingham, B15 2WB, United Kingdom.
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2020 (English)In: Arthritis Research & Therapy , E-ISSN 1478-6362, Vol. 22, no 1, article id 288Article in journal (Refereed) Published
Abstract [en]

Background: Preference assessments of patients with rheumatoid arthritis can support clinical therapeutic decisions for including biologic and targeted synthetic medicines to use. This study assesses patient preferences for attributes of second-line therapies and heterogeneity within these preferences to estimate the relative importance of treatment characteristics and to calculate the minimum benefit levels patients require to accept higher levels of side effects.

Methods: Between November 2018 to August 2019, patients with rheumatoid arthritis were recruited to a survey containing demographic and disease-related questions as well as a discrete choice experiment to measure their preferences for second-line therapies using biologics or Janus kinases inhibitors. Treatment characteristics included were route of administration, frequency of use, probability of mild short-term side effects, probability of side effects changing appearance, probability of psychological side effects, probability of severe side effects and effectiveness of treatment.

Results: A total of 358 patients were included in the analysis. A latent class analysis revealed three preference patterns: (1) treatment effectiveness as the single most important attribute, (2) route of administration as the most important attribute, closely followed by frequency of use and psychological side effects and (3) severe side effects as the most important attribute followed by psychological side effects. In addition, disease duration and mild side effects influenced the patients’ choices.

Conclusion: Respondents found either effectiveness, route of administration or severe side effects as the most important attribute. Patients noting effectiveness as most important were more willing than other patients to accept higher risks of side effects. 

Place, publisher, year, edition, pages
2020. Vol. 22, no 1, article id 288
Keywords [en]
Discrete choice experiment, Patient preferences, Rheumatoid arthritis, Second-line treatment
National Category
Rheumatology and Autoimmunity
Identifiers
URN: urn:nbn:se:mdh:diva-62339DOI: 10.1186/s13075-020-02391-wISI: 000600277400001PubMedID: 33341117Scopus ID: 2-s2.0-85097737642OAI: oai:DiVA.org:mdh-62339DiVA, id: diva2:1753397
Available from: 2023-04-27 Created: 2023-04-27 Last updated: 2024-07-04Bibliographically approved

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Schölin Bywall, Karin

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