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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

Relative importance scores for attributes in the discrete-choice experiment. The largest relative importance score was set equal to 10 and all other relative importance scores were calculated relative to the largest relative importance score
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Fig3: Relative importance scores for attributes in the discrete-choice experiment. The largest relative importance score was set equal to 10 and all other relative importance scores were calculated relative to the largest relative importance score

Mentions: Relative importance scores are presented in Fig. 3. The distance between preference weights for the best level and worst level of an attribute can be interpreted as the overall relative importance of the attribute over the range of levels assessed in the survey. Over the ranges of levels included in the study, out-of-pocket cost (between $0 and $200 per month) was the most important treatment attribute and was statistically significantly more important than efficacy, side effects, and dosing. Reduction in AG was statistically significantly more important than dosing and the remaining clinical outcomes. Hypoglycemia, chance of mild-to-moderate gastrointestinal side effects, weight change within the first 6 months of starting treatment, and incremental increase in the risk of CHF were of approximately equal importance. Once-weekly dosing was preferred to one pill once daily. One pill once daily was preferred to one pill twice daily, which, in turn, was preferred to two pills once daily. The difference in preference weights between the most preferred dosing option (one pill once weekly) and one pill once daily was positive and statistically significant; however, changes in dosing schedule were relatively less important than medication cost or changes in clinical outcomes over the ranges of attribute levels included in this study.Fig. 3


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)

Relative importance scores for attributes in the discrete-choice experiment. The largest relative importance score was set equal to 10 and all other relative importance scores were calculated relative to the largest relative importance score
© Copyright Policy
Related In: Results  -  Collection

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

Fig3: Relative importance scores for attributes in the discrete-choice experiment. The largest relative importance score was set equal to 10 and all other relative importance scores were calculated relative to the largest relative importance score
Mentions: Relative importance scores are presented in Fig. 3. The distance between preference weights for the best level and worst level of an attribute can be interpreted as the overall relative importance of the attribute over the range of levels assessed in the survey. Over the ranges of levels included in the study, out-of-pocket cost (between $0 and $200 per month) was the most important treatment attribute and was statistically significantly more important than efficacy, side effects, and dosing. Reduction in AG was statistically significantly more important than dosing and the remaining clinical outcomes. Hypoglycemia, chance of mild-to-moderate gastrointestinal side effects, weight change within the first 6 months of starting treatment, and incremental increase in the risk of CHF were of approximately equal importance. Once-weekly dosing was preferred to one pill once daily. One pill once daily was preferred to one pill twice daily, which, in turn, was preferred to two pills once daily. The difference in preference weights between the most preferred dosing option (one pill once weekly) and one pill once daily was positive and statistically significant; however, changes in dosing schedule were relatively less important than medication cost or changes in clinical outcomes over the ranges of attribute levels included in this study.Fig. 3

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