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A survey of patient preferences for oral antihyperglycemic therapy in patients with type 2 diabetes mellitus.

Hauber AB, Tunceli K, Yang JC, Gantz I, Brodovicz KG, Alexander CM, Davies MJ, Radican L - Diabetes Ther (2015)

Bottom Line: Reducing dosing frequency was statistically significantly important to patients; however, it was relatively less important than medication cost or clinical outcomes.On average, patients preferred once-weekly to once-daily dosing.For younger patients and patients not currently on treatment, once-weekly dosing may provide additional incentive to initiate and adhere to antihyperglycemic treatment; however, additional research will be required to confirm this hypothesis.

View Article: PubMed Central - PubMed

Affiliation: RTI Health Solutions, 200 Park Offices Drive, PO Box 12194, Research Triangle Park, NC, USA, abhauber@rti.org.

ABSTRACT

Introduction: Previous research has demonstrated a correlation among patient preferences, dosing burden, and medication nonadherence, a well-recognized challenge in type 2 diabetes mellitus (T2DM). The objective of this study was to elicit preferences for alternative dosing regimens for oral antihyperglycemic therapies among patients with T2DM and to quantify differences in dosing preferences among patients with different characteristics.

Methods: Preferences for dosing of oral antihyperglycemic drugs (OAD) were evaluated by surveying patients with T2DM in the United States (US). Survey participants were adult US patients with T2DM who were taking no or only 1 OAD and no injectable therapies. Each patient completed a web-enabled discrete-choice experiment (DCE) including a series of 8 pairs of hypothetical OAD profiles. Each profile was defined by reductions in average glucose, dosing schedule (e.g., once-weekly, once-daily, or twice-daily dosing), chance of mild-to-moderate gastrointestinal side effects, frequency of hypoglycemia, weight change, incremental risk of congestive heart failure, and cost. Each participant also answered a direct question about dosing preference. Random-parameters logit was used to analyze the DCE data. Prespecified subgroups were analyzed.

Results: Of 2,262 patients invited to participate, 923 were included in the analysis (mean age 63 years, 45% male, 79% white). Reducing dosing frequency was statistically significantly important to patients; however, it was relatively less important than medication cost or clinical outcomes. On average, patients preferred once-weekly to once-daily dosing. Patients not currently taking an OAD had a stronger preference for once-weekly dosing than patients on treatment (P = 0.012). Patients younger than 45 years had a stronger preference for weekly dosing than older patients (P < 0.075).

Conclusions: For younger patients and patients not currently on treatment, once-weekly dosing may provide additional incentive to initiate and adhere to antihyperglycemic treatment; however, additional research will be required to confirm this hypothesis.

No MeSH data available.


Related in: MedlinePlus

Example of a choice question in the discrete-choice experiment. CHF congestive heart failure
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Fig1: Example of a choice question in the discrete-choice experiment. CHF congestive heart failure

Mentions: The online DCE survey was adapted from a survey used in a previous study [7] and developed using good research practices [13]. The survey included a series of eight choice questions; each question presented a pair of hypothetical, but realistic, OAD medication profiles (Fig. 1). Patients were asked to choose their preferred medication profile in each pair. Each profile was defined by five clinical outcomes, dosing schedule, and out-of-pocket cost. Clinical outcomes included reduction in average glucose (AG) [17] (between 20 and 66 mg/dL) from a baseline of 206 mg/dL, chance of mild-to-moderate gastrointestinal side effects (between 10% and 30%), frequency of hypoglycemia (between none and >2 hypoglycemic episodes per month), weight change within the first 6 months after starting treatment (between 6 lb weight gain and 6 lb weight loss), and incremental treatment-related risk of congestive heart failure (CHF) (between 0% and 3%). The combination of attributes in each medication profile and the pairing of profiles in each choice question were determined by an experimental design with known statistical properties developed using good research practices [18].Fig. 1


A survey of patient preferences for oral antihyperglycemic therapy in patients with type 2 diabetes mellitus.

Hauber AB, Tunceli K, Yang JC, Gantz I, Brodovicz KG, Alexander CM, Davies MJ, Radican L - Diabetes Ther (2015)

Example of a choice question in the discrete-choice experiment. CHF congestive heart failure
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4374080&req=5

Fig1: Example of a choice question in the discrete-choice experiment. CHF congestive heart failure
Mentions: The online DCE survey was adapted from a survey used in a previous study [7] and developed using good research practices [13]. The survey included a series of eight choice questions; each question presented a pair of hypothetical, but realistic, OAD medication profiles (Fig. 1). Patients were asked to choose their preferred medication profile in each pair. Each profile was defined by five clinical outcomes, dosing schedule, and out-of-pocket cost. Clinical outcomes included reduction in average glucose (AG) [17] (between 20 and 66 mg/dL) from a baseline of 206 mg/dL, chance of mild-to-moderate gastrointestinal side effects (between 10% and 30%), frequency of hypoglycemia (between none and >2 hypoglycemic episodes per month), weight change within the first 6 months after starting treatment (between 6 lb weight gain and 6 lb weight loss), and incremental treatment-related risk of congestive heart failure (CHF) (between 0% and 3%). The combination of attributes in each medication profile and the pairing of profiles in each choice question were determined by an experimental design with known statistical properties developed using good research practices [18].Fig. 1

Bottom Line: Reducing dosing frequency was statistically significantly important to patients; however, it was relatively less important than medication cost or clinical outcomes.On average, patients preferred once-weekly to once-daily dosing.For younger patients and patients not currently on treatment, once-weekly dosing may provide additional incentive to initiate and adhere to antihyperglycemic treatment; however, additional research will be required to confirm this hypothesis.

View Article: PubMed Central - PubMed

Affiliation: RTI Health Solutions, 200 Park Offices Drive, PO Box 12194, Research Triangle Park, NC, USA, abhauber@rti.org.

ABSTRACT

Introduction: Previous research has demonstrated a correlation among patient preferences, dosing burden, and medication nonadherence, a well-recognized challenge in type 2 diabetes mellitus (T2DM). The objective of this study was to elicit preferences for alternative dosing regimens for oral antihyperglycemic therapies among patients with T2DM and to quantify differences in dosing preferences among patients with different characteristics.

Methods: Preferences for dosing of oral antihyperglycemic drugs (OAD) were evaluated by surveying patients with T2DM in the United States (US). Survey participants were adult US patients with T2DM who were taking no or only 1 OAD and no injectable therapies. Each patient completed a web-enabled discrete-choice experiment (DCE) including a series of 8 pairs of hypothetical OAD profiles. Each profile was defined by reductions in average glucose, dosing schedule (e.g., once-weekly, once-daily, or twice-daily dosing), chance of mild-to-moderate gastrointestinal side effects, frequency of hypoglycemia, weight change, incremental risk of congestive heart failure, and cost. Each participant also answered a direct question about dosing preference. Random-parameters logit was used to analyze the DCE data. Prespecified subgroups were analyzed.

Results: Of 2,262 patients invited to participate, 923 were included in the analysis (mean age 63 years, 45% male, 79% white). Reducing dosing frequency was statistically significantly important to patients; however, it was relatively less important than medication cost or clinical outcomes. On average, patients preferred once-weekly to once-daily dosing. Patients not currently taking an OAD had a stronger preference for once-weekly dosing than patients on treatment (P = 0.012). Patients younger than 45 years had a stronger preference for weekly dosing than older patients (P < 0.075).

Conclusions: For younger patients and patients not currently on treatment, once-weekly dosing may provide additional incentive to initiate and adhere to antihyperglycemic treatment; however, additional research will be required to confirm this hypothesis.

No MeSH data available.


Related in: MedlinePlus