PMID- 32762985
OWN - NLM
STAT- MEDLINE
DCOM- 20200922
LR  - 20200922
IS  - 1524-4733 (Electronic)
IS  - 1098-3015 (Linking)
VI  - 23
IP  - 7
DP  - 2020 Jul
TI  - Patient Preferences for Medications in Managing Type 2 Diabetes Mellitus: A 
      Discrete Choice Experiment.
PG  - 842-850
LID - S1098-3015(20)30182-0 [pii]
LID - 10.1016/j.jval.2020.01.023 [doi]
AB  - OBJECTIVES: To quantify patients' maximum acceptable risk (MAR) of urinary and 
      genital tract infections (UGTI) in exchange for benefits associated with 
      treatments for managing type 2 diabetes mellitus (T2DM). METHODS: In a discrete 
      choice experiment, adult patients with T2DM and currently on metformin and/or 
      sulphonylurea (first-line treatments) were asked to choose between 2 hypothetical 
      medications defined by 6 attributes: years of medication effectiveness in 
      controlling blood glucose, weight reduction, UGTI risk, risk of hospitalization 
      from heart failure, all-cause mortality risk, and out-of-pocket medication cost. 
      We used latent class logistic regression parameters to estimate the conditional 
      relative importance of treatment attributes and MAR of UGTI for various treatment 
      benefits. RESULTS: A 2-class latent class model was identified as the best fit 
      for the responses from 147 patients. The first class (49% of sample), termed as 
      "survival-conscious," stated that they were willing to accept 46% (95% confidence 
      interval [CI]: 2%-90%) UGTI risk in exchange for a reduction from 6% to 1% in 
      all-cause mortality risk. The second class (51% of sample), termed as 
      "UGTI/cost-conscious" were willing to accept significantly lower (6%; CI: 2%-11%, 
      and 5%; CI: 2%-8%) UGTI risk in exchange for the same reduction in all-cause 
      mortality and hospitalization risks, respectively. CONCLUSIONS: On average, 
      patients were willing to trade higher UGTI risk for a more effective medication. 
      Our findings suggest that physicians should present the benefits and potential 
      side effects of all available treatments and consider patient preferences in 
      their treatment recommendations.
CI  - Copyright (c) 2020 ISPOR-The Professional Society for Health Economics and Outcomes 
      Research. Published by Elsevier Inc. All rights reserved.
FAU - Ozdemir, Semra
AU  - Ozdemir S
AD  - Signature Program in Health Services and Systems Research, Duke-NUS Medical 
      School, Singapore; Lien Centre for Palliative Care, Duke-NUS Medical School, 
      Singapore. Electronic address: semra.ozdemir@duke-nus.edu.sg.
FAU - Baid, Drishti
AU  - Baid D
AD  - Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.
FAU - Verghese, Naina R
AU  - Verghese NR
AD  - Signature Program in Health Services and Systems Research, Duke-NUS Medical 
      School, Singapore.
FAU - Lam, Amanda Yr
AU  - Lam AY
AD  - Department of Endocrinology, Singapore General Hospital, Singapore.
FAU - Lee, Phong Ching
AU  - Lee PC
AD  - Department of Endocrinology, Singapore General Hospital, Singapore.
FAU - Lim, Adoree Yy
AU  - Lim AY
AD  - Department of Endocrinology, Singapore General Hospital, Singapore.
FAU - Zhu, Ling
AU  - Zhu L
AD  - Department of Endocrinology, Singapore General Hospital, Singapore.
FAU - Ganguly, Sonali
AU  - Ganguly S
AD  - Department of Endocrinology, Singapore General Hospital, Singapore.
FAU - Finkelstein, Eric A
AU  - Finkelstein EA
AD  - Signature Program in Health Services and Systems Research, Duke-NUS Medical 
      School, Singapore; Lien Centre for Palliative Care, Duke-NUS Medical School, 
      Singapore; Saw Swee Hock School of Public Health, National University of 
      Singapore, Singapore; Global Health Institute, Duke University, Durham, NC, USA.
FAU - Goh, Su-Yen
AU  - Goh SY
AD  - Department of Endocrinology, Singapore General Hospital, Singapore.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200621
PL  - United States
TA  - Value Health
JT  - Value in health : the journal of the International Society for Pharmacoeconomics 
      and Outcomes Research
JID - 100883818
RN  - 0 (Blood Glucose)
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Aged
MH  - Blood Glucose/drug effects
MH  - *Choice Behavior
MH  - Diabetes Mellitus, Type 2/*drug therapy
MH  - Female
MH  - Health Expenditures
MH  - Hospitalization/statistics & numerical data
MH  - Humans
MH  - Hypoglycemic Agents/*administration & dosage/adverse effects
MH  - Male
MH  - Middle Aged
MH  - *Patient Preference
MH  - Reproductive Tract Infections/epidemiology
MH  - Urinary Tract Infections/epidemiology
MH  - Weight Loss/drug effects
OTO - NOTNLM
OT  - diabetes
OT  - discrete choice experiment
OT  - maximum acceptable risk
OT  - patient preference
EDAT- 2020/08/09 06:00
MHDA- 2020/09/23 06:00
CRDT- 2020/08/09 06:00
PHST- 2019/08/16 00:00 [received]
PHST- 2019/12/06 00:00 [revised]
PHST- 2020/01/24 00:00 [accepted]
PHST- 2020/08/09 06:00 [entrez]
PHST- 2020/08/09 06:00 [pubmed]
PHST- 2020/09/23 06:00 [medline]
AID - S1098-3015(20)30182-0 [pii]
AID - 10.1016/j.jval.2020.01.023 [doi]
PST - ppublish
SO  - Value Health. 2020 Jul;23(7):842-850. doi: 10.1016/j.jval.2020.01.023. Epub 2020 
      Jun 21.