PMID- 26682548
OWN - NLM
STAT- MEDLINE
DCOM- 20170518
LR  - 20181113
IS  - 1618-7601 (Electronic)
IS  - 1618-7598 (Linking)
VI  - 17
IP  - 9
DP  - 2016 Dec
TI  - What matters in type 2 diabetes mellitus oral treatment? A discrete choice 
      experiment to evaluate patient preferences.
PG  - 1125-1140
AB  - AIMS: The aim of this empirical study is to evaluate patient preferences for 
      different characteristics of oral type 2 diabetes mellitus (T2DM) treatment. As 
      T2DM treatment requires strict adherence, patient needs and preferences should be 
      taken into consideration. METHODS: Based on a qualitative and quantitative 
      analysis, a discrete choice experiment (DCE) was applied to identify patient 
      preferences. Apart from six identical attributes (adjustment of glycated 
      hemoglobin [HbA1c], prevention of hypoglycemia, risk of genital infection, risk 
      of gastrointestinal problems, risk of urinary tract infection, and weight 
      change), one continuous variable of either "additional healthy life years" (AHY) 
      or "additional costs" attribute (AC) was included. The DCE was conducted using a 
      fractional factorial design, and the statistical data analysis used random effect 
      logit models. RESULTS: In total, N = 626 (N = 318 AHY + N = 308 AC) T2DM patients 
      participated in the survey. The estimation revealed a clear dominance for 
      prevention of hypoglycemia (coefficient 0.937) and adjustment of HbA1c 
      (coefficient 0.541). The attributes, "additional healthy life years" (coefficient 
      0.458) or "additional costs" (coefficient 0.420), were in the middle rank and 
      both of significant impact. The side effects, risk of genital infection 
      (coefficient 0.301), risk of gastrointestinal problems (coefficient 0.296), and 
      risk of urinary tract infection (coefficient 0.241) followed in this respective 
      order. Possible weight change (coefficient 0.047) was of less importance (last 
      rank) to the patients in this evaluation. CONCLUSIONS: These survey results 
      demonstrate how much a (hypothetical) T2DM oral treatment characteristic affects 
      the treatment decision. The preference data can be used for risk-benefit 
      assessment, cost-benefit assessment, and the establishment of patient-oriented 
      evidence. Understanding how patients perceive and value different aspects of 
      diabetes oral treatment is vital to the optimal design and evaluation of 
      treatment options. The present results can be an additional source of information 
      for design, assessment, and decision in T2DM treatment regimes. As such, more 
      effective and efficient care of patients can be achieved, thereby increasing 
      adherence.
FAU - Muhlbacher, Axel
AU  - Muhlbacher A
AD  - Hochschule Neubrandenburg, Neubrandenburg, Germany. muehlbacher@hs-nb.de.
AD  - Gesellschaft fur empirische Beratung mbH, Denzlingen, Germany. 
      muehlbacher@hs-nb.de.
FAU - Bethge, Susanne
AU  - Bethge S
AD  - Hochschule Neubrandenburg, Neubrandenburg, Germany.
LA  - eng
PT  - Journal Article
DEP - 20151218
PL  - Germany
TA  - Eur J Health Econ
JT  - The European journal of health economics : HEPAC : health economics in prevention 
      and care
JID - 101134867
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Administration, Oral
MH  - Adult
MH  - Aged
MH  - *Choice Behavior
MH  - Cost-Benefit Analysis
MH  - Diabetes Complications
MH  - Diabetes Mellitus, Type 2/drug therapy/economics/*psychology
MH  - Female
MH  - Germany
MH  - *Health Knowledge, Attitudes, Practice
MH  - Humans
MH  - Hypoglycemia/*prevention & control
MH  - Hypoglycemic Agents/economics/therapeutic use
MH  - Interviews as Topic
MH  - Linear Models
MH  - Male
MH  - Medication Adherence/*psychology
MH  - Middle Aged
MH  - Patient Preference
OTO - NOTNLM
OT  - Discrete choice experiment
OT  - Oral treatment
OT  - Patient preferences
OT  - Type 2 diabetes mellitus
EDAT- 2016/10/27 06:00
MHDA- 2017/05/19 06:00
CRDT- 2015/12/20 06:00
PHST- 2015/05/29 00:00 [received]
PHST- 2015/11/18 00:00 [accepted]
PHST- 2016/10/27 06:00 [pubmed]
PHST- 2017/05/19 06:00 [medline]
PHST- 2015/12/20 06:00 [entrez]
AID - 10.1007/s10198-015-0750-5 [pii]
AID - 10.1007/s10198-015-0750-5 [doi]
PST - ppublish
SO  - Eur J Health Econ. 2016 Dec;17(9):1125-1140. doi: 10.1007/s10198-015-0750-5. Epub 
      2015 Dec 18.