Patient preferences for the treatment of systemic sclerosis-associated interstitial lung disease: a discrete choice experiment

Bruni C, Heidenreich S, Duenas A, Hoffmann-Vold AM, Gabrielli A, Allanore Y, Chatelus E, Distler J, Hachulla E, Hsu VM, Hunzelmann N, Khanna D, Truchetet ME, Walker UA, Alves M, Schoof N, Saketkoo LA, Distler O (2022)

Publication Type: Journal article

Publication year: 2022

Journal

DOI: 10.1093/rheumatology/keac126

Abstract

Objectives Treatments for SSc-associated interstitial lung disease (SSc-ILD) differ in attributes, i.e. mode of administration, adverse events (AEs) and efficacy. As physicians and patients may perceive treatments differently, shared decision-making can be essential for optimal treatment provision. We therefore aimed to quantify patient preferences for different treatment attributes. Methods Seven SSc-ILD attributes were identified from mixed-methods research and clinician input: mode of administration, shortness of breath, skin tightness, cough, tiredness, risk of gastrointestinal AEs (GI-AEs) and risk of serious and non-serious infections. Patients with SSc-ILD completed an online discrete choice experiment (DCE) in which they were asked to repeatedly choose between two alternatives characterized by varying severity levels of the included attributes. The data were analysed using a multinomial logit model; relative attribute importance and maximum acceptable risk measures were calculated. Results Overall, 231 patients with SSc-ILD completed the DCE. Patients preferred twice-daily oral treatments and 6-12 monthly infusions. Patients' choices were mostly influenced by the risk of GI-AEs or infections. Improvement was more important in respiratory symptoms than in skin tightness. Concerning trade-offs, patients accepted different levels of increase in GI-AE risk: +21% if it reduced the infusions' frequency; +15% if changing to an oral treatment; up to +37% if it improved breathlessness; and up to +36% if it reduced the risk of infections. Conclusions This is the first study to quantitatively elicit patients' preferences for treatment attributes in SSc-ILD. Patients showed willingness to make trade-offs, providing a firm basis for shared decision-making in clinical practice.

Authors with CRIS profile

Involved external institutions

Università degli Studi di Firenze / University of Florence Italy (IT) Evidera United States (USA) (US) LILLE 1 University - Science and Technology France (FR) The State University of New Jersey (Rutgers) United States (USA) (US) Universität zu Köln Germany (DE) University of Michigan United States (USA) (US) Centre Hospitalier Universitaire de Bordeaux / CHU Bordeaux France (FR) Universitätsspital Basel Switzerland (CH) Boehringer Ingelheim Pharma GmbH & Co. KG Germany (DE) Oslo University Hospital / Oslo Universitetssykehus Rikshospitalet Norway (NO) Università Politecnica delle Marche (UNIVPM) / Marche Polytechnic University Italy (IT) University of Paris 5 - René Descartes / Université Paris V René Descartes France (FR) Hôpitaux universitaires de Strasbourg (HUS) / University Hospital Strasbourg France (FR) Louisiana State University Health Sciences Center United States (USA) (US) University of Zurich / Universität Zürich (UZH) Switzerland (CH)

How to cite

APA:

Bruni, C., Heidenreich, S., Duenas, A., Hoffmann-Vold, A.-M., Gabrielli, A., Allanore, Y.,... Distler, O. (2022). Patient preferences for the treatment of systemic sclerosis-associated interstitial lung disease: a discrete choice experiment. Rheumatology. https://dx.doi.org/10.1093/rheumatology/keac126

MLA:

Bruni, Cosimo, et al. "Patient preferences for the treatment of systemic sclerosis-associated interstitial lung disease: a discrete choice experiment." Rheumatology (2022).

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