Patient preferences for characteristics of antiretroviral therapies: results from five European countries

Abstract

IntroductionPatient preference to antiretroviral therapy (ART) characteristics should be a key consideration in treatment decisions. ART options exist for people living with HIV (PLWH), however concerns remain related to PLWH satisfaction with current ARTs. The current study examines patient preferences and the strength of preferences for treatment characteristics associated with ART.Materials and MethodsPatients’ preferences to ART were explored using a discrete choice experiment (DCE). Seven defined treatment characteristics (each with three categories) were identified from a literature review, input from experts, PLWH and physicians. A total of 1582 PLWH from France, Germany, Spain, Italy and the UK were recruited for the study. An adjusted odds ratio <1 signified lower odds of selecting a treatment with this characteristic category, compared to the reference category, independently of other characteristics.ResultsThe patient preference analyses showed that participants preferred treatments with a rapid reduction in viral load (OR=0.78; 95% CI 0.74–0.81) and CD4 count (OR=0.86; 95% CI=0.82–0.89). Participants had a strong preference for avoiding diarrhoea (Odds ratio, OR=0.36 95% CI=0.33–0.38) and long term health problems (OR=0.30, 95% CI=0.28–0.32). Convenience related issues related to restrictions on taking drugs because of food or drug interactions were important to avoid (OR=0.80, 95% CI=0.76–0.83 and OR=0.72 95% CI=0.69–0.76 respectively). Participants also had a strong preference to avoid drugs which limited the effectiveness of future treatments (OR=0.70, 95% CI=0.67–0.73).ConclusionsAvoidance of diarrhoea and long-term complications were the most important drivers of patient choice. This study, from a large sample of European patients, demonstrates the importance to patients when different aspects of HIV treatment are considered simultaneously.

Brief Report: Factors Associated With the Selection of Initial Antiretroviral Therapy From 2009 to 2012

“…Future studies should address the impact of the newer integrase inhibitors and the role of nucleoside/tide backbone selection in combination with the anchor drugs of the regimen. Finally, our study cannot dissect the role patient preference plays in the selection of regimens (18). …”

A discrete choice experiment to assess patients’ preferences for HIV treatment in the rural population in Colombia

“…First, a literature review in PubMed was conducted to examine which attributes were used in previous DCEs on patients' preferences in HIV treatment [16][17][18][19][20][21]30 . In addition, a previous best-worst scaling study of Hendriks et al 22 , which identified the most important treatment characteristics of HIV patients in Colombia, was used as the main basis for the attributes of the present study.…”

“…Stated preference studies are increasingly used to elicit patients' preferences in healthcare [13][14][15] . Over the last years, several preference studies on HIV treatment have been conducted in developed countries [16][17][18] , revealing the importance of efficacy of treatment and quality-of-life for HIV patients. Likewise some preference studies were conducted in developing countries, including Tanzania 19 , Thailand 20 , South Africa 21 , and Colombia 22 .…”

Effect of a High‐Fat Meal on the Pharmacokinetics of the HIV Integrase Inhibitor Cabotegravir

“…However, the success of antiretroviral therapy depends on patient compliance with treatment regimens, with incomplete adherence potentially leading to drug resistance or treatment failure . In addition, some regimens require coadministration with food, thus impacting dosing convenience and adherence . Treatment regimens that provide an alternative to oral dosing could improve convenience, increase compliance, and potentially lead to better treatment outcomes for some patients.…”

“…1 In addition, some regimens require coadministration with food, thus impacting dosing convenience and adherence. [2][3][4] Treatment regimens that provide an alternative to oral dosing could improve convenience, increase compliance, and potentially lead to better treatment outcomes for some patients.…”