&lt;p&gt;Evaluating Patient Preferences of Maintenance Therapy for the Treatment of Chronic Obstructive Pulmonary Disease: A Discrete Choice Experiment in the UK, USA and Germany&lt;/p&gt;

Lewis, Heather; Schroeder, Melanie; Gunsoy, Necdet; Janssen, Ellen; Llewellyn, Samuel; Doll, Helen; Jones, Paul; Ismaila, Afisi S

doi:10.2147/copd.s221980

Cited by 8 publications

(6 citation statements)

References 17 publications

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“…Reducing the number of inhalers required and frequency of use should improve treatment persistence and adherence, which could in turn improve clinical effectiveness and patient outcomes [ 4 , 5 ]. Fewer inhalers and reduced treatment complexity has been highlighted as a preferred treatment strategy for patients with COPD [ 6 , 7 ]. In addition, the use of multiple inhalers has been associated with more frequent errors in inhaler technique compared with therapy administered via a single inhaler [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

INTREPID: single- versus multiple-inhaler triple therapy for COPD in usual clinical practice

et al. 2021

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IntroductionReal-world trial data comparing single- with multiple-inhaler triple therapy (MITT) in COPD patients are currently lacking. The effectiveness of once-daily single-inhaler fluticasone furoate (FF)/umeclidinium (UMEC)/vilanterol (VI) and MITT were compared in usual clinical care.MethodsINTREPID was a multicentre, randomised, open-label, phase IV effectiveness study comparing FF/UMEC/VI 100/62.5/25 µg via the ELLIPTA inhaler with a clinician's choice of any approved non-ELLIPTA MITT in usual COPD clinical practice in five European countries. Primary end-point was proportion of COPD Assessment Test (CAT) responders (≥2-unit decrease in CAT score from baseline) at week 24. Secondary end-points in a subpopulation included change from baseline in forced expiratory volume in 1 s (FEV1) and percentage of patients making at least one critical error in inhalation technique at week 24. Safety was also assessed.Results3092 patients were included (FF/UMEC/VI n=1545; MITT n=1547). The proportion of CAT responders at week 24 was significantly greater with FF/UMEC/VI versus non-ELLIPTA MITT (OR 1.31, 95% CI 1.13–1.51; p<0.001) and mean change from baseline in FEV1 was significantly greater with FF/UMEC/VI (77 mL versus 28 mL; treatment difference 50 mL, 95% CI 26–73 mL; p<0.001). The percentage of patients with at least one critical error in inhalation technique was low in both groups (FF/UMEC/VI 6%; non-ELLIPTA MITT 3%). Safety profiles, including incidence of pneumonia serious adverse events, were similar between treatments.ConclusionsIn a usual clinical care setting, treatment with once-daily single-inhaler FF/UMEC/VI resulted in significantly more patients gaining health status improvement and greater lung function improvement versus non-ELLIPTA MITT.

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Section: Introductionmentioning

confidence: 99%

INTREPID: single- versus multiple-inhaler triple therapy for COPD in usual clinical practice

et al. 2021

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“…dose release, preparation, etc. ), Indicates empty (n = 1), Reusability (n = 2), Technology (n = 1 ) [ 15 , 23 , 25 , 29 , 30 , 32 , 33 , 35 , 36 , 42 , 49 ] 11 (39) 6 (32) 8 (67) Treatment cost [ 24 , 27 , 29 , 31 – 38 , 41 , 42 , 48 – 50 , 53 ] 17 (61) 12 (63) 7 (58) Other [ 24 , 28 , 30 , 33 , 35 , 42 , 43 , 48 , 50 , 53 ] 10 (36) 8 (42) 4 (33) Other: Treatment Class of compound (n = 1), Patient satisfaction (n = 1) [ 42 ] 1 (4) 0 (0) 1 (8) Other: Evidence Evidence of compliance (n = 1), Duration of evidence (n = 1), FDA approval (n = 1) [ 30 , 42 , 50 ] 3 (11) 2 (11) 1 (8) ...…”

Section: Resultsmentioning

confidence: 99%

“…Eight (29%) studies were conducted in both the US and the UK, with several others conducted in Australia ( n = 4, 14%), France ( n = 3, 11%) [ 25 , 29 , 42 ], Germany ( n = 3, 11%) [ 36 , 42 , 47 ] and the Netherlands ( n = 3, 11%) [ 26 , 38 , 53 ]. No studies were conducted in South America, Africa or Asia, meaning that no evidence is currently available on stakeholders’ preferences across those regions.…”

Section: Discussionmentioning

confidence: 99%

A Systematic and Critical Review of Discrete Choice Experiments in Asthma and Chronic Obstructive Pulmonary Disease

Collacott¹,

Zhang

Heidenreich³

et al. 2021

Patient

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Background Regulators have called for greater emphasis on the role of the patient voice to inform medical product development and decision making, and expert guidelines and reports for asthma and chronic obstructive pulmonary disease (COPD) both explicitly recommend the consideration of patient preferences in the management of these diseases. Discrete choice experiments (DCEs) are commonly used to quantify stakeholders' treatment preferences and estimate the trade-offs they are willing to make between outcomes such as treatment benefits and risks. Objective The aim of this systematic literature review is to provide an up-to-date and critical review of DCEs published in asthma and COPD; specifically, we aim to evaluate the subject of preference studies conducted in asthma and COPD, what attributes have been included, stakeholders' preferences, and the consistency in reporting of instrument development, testing and reporting of results. Methods A systematic review of published DCEs on asthma and COPD treatments was conducted using Embase, Medline and the Cochrane Database of Systematic Reviews. Studies were included if they included a DCE conducted in a relevant population (e.g. patients with asthma or COPD or their caregivers, asthma or COPD-treating clinicians, or the general population), and reported quantitative outcomes on participants' preferences. Study characteristics were summarised descriptively, and descriptive analyses of attribute categories, consistency in reporting on key criteria, and stakeholder preferences were undertaken. Results A total of 33 eligible studies were identified, including 28 unique DCEs. The majority (n = 20; 71%) of studies were conducted in a patient sample. Studies focused on inhaler treatments, and included attributes in five key categories: symptoms and treatment benefits (n = 23; 82%), treatment convenience (n = 19; 68%), treatment cost (n = 17; 61%), treatment risks (n = 13; 46%), and other (n = 10; 36%). Symptoms and treatment benefits were the attributes most frequently ranked as important to patients (n = 26, 72%), followed by treatment risks (n = 7, 39%). Several studies (n = 9, 32%) did not qualitatively pre-test their DCE, and a majority did not report the uncertainty in estimated outcomes (n = 18; 64%). Conclusions DCEs in asthma and COPD have focused on treatment benefits and convenience, with less evidence generated on participants' risk tolerance. Quality criteria and reporting standards are needed to promote study quality and ensure consistency in reporting between studies.

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“…This poor compliance may particularly reflect challenges in complying with multiple-inhaler regimens in general. Indeed, up to 65% of patients with COPD from the US, Germany, and the UK preferred a once-daily single-inhaler regimen over a twice-daily dual-inhaler regimen [ 26 ]. Likewise, a US study reported a significantly higher discontinuation rate with multiple-inhaler COPD therapy than single-inhaler COPD therapy [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Treatment patterns and cost of exacerbations in patients with chronic obstructive pulmonary disease using multiple inhaler triple therapy in South Korea

Lee

Kim

Yeo³

et al. 2022

Respir Res

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Background Multiple inhaler triple therapy (MITT), comprising inhaled corticosteroids (ICS), long-acting beta-agonists (LABA), and long-acting muscarinic antagonists (LAMA), has been used as an escalation treatment for patients with chronic obstructive pulmonary disease (COPD). However, real-world use of MITT has not been investigated in Asia, including South Korea. This study reports baseline characteristics of patients with COPD initiated on MITT in South Korea, and their treatment patterns. Healthcare resource utilization (HRU) and costs associated with COPD exacerbations following MITT initiation were also assessed. Methods This was a retrospective cohort study using the South Korea National Health Insurance database (2014–2018). Included patients were ≥ 40 years, had a COPD diagnosis, were newly initiated on MITT and had ≥ 12 months’ data both before (baseline) and after index date (the first day with overlapping supply of all MITT components). Treatment immediately before initiation and immediately following discontinuation of MITT were identified, and proportion of days covered (PDC) by MITT was calculated. HRU and costs (per person per year [PPPY]) associated with exacerbations were identified following MITT initiation; costs were calculated using the average 2020 exchange rate (0.0008 USD/KRW). Results Among 37,400 patients, the mean age was 69 (SD 10) years and 73% were males; 56% had ≥ 1 COPD exacerbation during the baseline period, with a mean of 2 (SD 5) events/year. ICS/LABA was the most frequent regimen prescribed immediately before initiation (37%) and immediately following discontinuation (41% of 34,264 patients) of MITT. At 3, 6, and 12 months from treatment initiation, mean PDC was 81%, 63% and 49%, respectively; median treatment duration was 102 days. The mean (95% confidence interval [CI]) number of total visits for severe COPD exacerbations was 0.77 PPPY (0.75–0.78); mean PPPY total healthcare costs were 2093 USD. Conclusions Patients with COPD in South Korea experienced frequent exacerbations prior to MITT, and PDC by MITT was low. Patients may benefit from early optimization of COPD therapy, and greater emphasis on adherence to inhaled COPD therapy. Severe exacerbations were found to incur substantial costs; treatment alternatives that can reduce the rate of severe exacerbations are likely to minimize healthcare costs.

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<p>Evaluating Patient Preferences of Maintenance Therapy for the Treatment of Chronic Obstructive Pulmonary Disease: A Discrete Choice Experiment in the UK, USA and Germany</p>

Cited by 8 publications

References 17 publications

INTREPID: single- versus multiple-inhaler triple therapy for COPD in usual clinical practice

INTREPID: single- versus multiple-inhaler triple therapy for COPD in usual clinical practice

A Systematic and Critical Review of Discrete Choice Experiments in Asthma and Chronic Obstructive Pulmonary Disease

Treatment patterns and cost of exacerbations in patients with chronic obstructive pulmonary disease using multiple inhaler triple therapy in South Korea

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