Patient preferences for managing asthma: results from a discrete choice experiment

Abstract

Effective control of asthma requires regular preventive medication. Poor medication adherence suggests that patient preferences for medications may differ from the concerns of the prescribing clinicians. This study investigated patient preferences for preventive medications across symptom control, daily activities, medication side-effects, convenience and costs, using a discrete choice experiment embedded in a randomized clinical trial involving patients with mild-moderate persistent asthma. The present data were collected after patients had received 6 weeks' treatment with one of two drugs. Three choice options were presented, to continue with the current drug, to change to an alternative, hypothetical drug, or to take no preventive medication. Analysis used random parameter multinomial logit. Most respondents chose to continue with their current drug in most choice situations but this tendency differed depending on which medication they had been allocated. Respondents valued their ability to participate in usual daily activities and sport, preferred minimal symptoms, and were less likely to choose drugs with side-effects. Cost was also significant, but other convenience attributes were not. Demographic characteristics did not improve the model fit. This study illustrates how discrete choice experiments may be embedded in a clinical trial to provide insights into patient preferences.

A discrete choice experiment investigating preferences for funding drugs used to treat orphan diseases: an exploratory study

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Effectiveness and acceptability of parental financial incentives and quasi-mandatory schemes for increasing uptake of vaccinations in preschool children: systematic review, qualitative study and discrete choice experiment

“…Previous studies using DCEs for exploring experience factors in health-care settings have included samples ranging from fewer than 50 112 to almost 4000, 113 and robust choice models have been estimated from sample sizes of between 50 and 100 respondents. 114 Optimal sample size requirements for DCEs depend on knowledge of the true choice probabilities, which are not known prior to undertaking the research 115 and, therefore, DCE sample size estimates are generally based on rules-of-thumb and budget constraints. Given the number of attributes included in the DCE, it was estimated that a minimum sample size of 400 [i.e.…”

Factors that influence variation in clinical decision-making about thrombolysis in the treatment of acute ischaemic stroke: results of a discrete choice experiment

“…73 However, previous DCE studies have shown that robust choice models can be estimated from sample sizes of between 50 and 100 respondents. 92,93 Based on previous studies and estimates of the total number of clinicians treating acute stroke patients in the UK, a sample size of 150-200 was anticipated as achievable in the current study. This estimate represents approximately 35-47% of the 422 clinicians registered as 'full members' of the British Association of Stroke Physicians (BASP), although the proportion involved in thrombolysis decision-making was unknown.…”