PMID- 34854164
OWN - NLM
STAT- MEDLINE
DCOM- 20220304
LR  - 20231115
IS  - 1532-2149 (Electronic)
IS  - 1090-3801 (Print)
IS  - 1090-3801 (Linking)
VI  - 26
IP  - 3
DP  - 2022 Mar
TI  - Exploring patient preference heterogeneity for pharmacological treatments for 
      chronic pain: A latent class analysis.
PG  - 648-667
LID - 10.1002/ejp.1892 [doi]
AB  - BACKGROUND: Several pharmaceutical treatments for chronic pain caused by 
      osteoarthritis (OA) and chronic low back pain (CLBP) are available or currently 
      under development, each associated with different adverse events (AEs) and 
      efficacy profiles. It is therefore important to understand what trade-offs 
      patients are willing to make when choosing between treatments. METHODS: A 
      discrete-choice experiment (DCE) was conducted with 437 adults with chronic pain 
      caused by OA and/or CLBP. Respondents were presented with a series of scenarios 
      and asked to choose between pairs of hypothetical treatments, each defined by six 
      attributes: level of symptom control; risks of heart attack, rapidly progressive 
      osteoarthritis and dependency; frequency and mode of administration and cost. 
      Attributes were based on known profiles of oral nonsteroidal anti-inflammatory 
      drugs, opioids and injected nerve growth factor inhibitors, the last of which 
      were under clinical development at the time of the study. Data were analysed 
      using a latent class (LC) model to explore preference heterogeneity. RESULTS: 
      Overall, respondents considered improving symptom control and reducing risk of 
      physical dependency to be the most important attributes. The LC analysis 
      identified four participant classes: an 'efficacy-focused' class (33.7%), a 
      'cost-averse' class (29.4%), a 'physical-dependence-averse' class (19.6%) and a 
      'needle-averse' class (17.3%). Subgroup membership was incompletely predicted by 
      participant age and their responses to comprehension questions. CONCLUSIONS: 
      Preference heterogeneity across respondents indicates a need for a personalized 
      approach to offering treatment options. Symptom improvement, cost, physical 
      dependence and route of administration might be important to different patients. 
      SIGNIFICANCE: Multiple treatment options that differ substantially in terms of 
      efficacy and adverse events are available for the management of chronic pain. 
      With a growing emphasis on a patient-centred care model that incorporates 
      patients' priorities and values into treatment decisions, there is a need to 
      understand how individuals with chronic musculoskeletal pain balance the benefits 
      and risks of treatment and how treatment priorities vary among individuals. This 
      study was designed to identify patient preferences for different characteristics 
      of treatments for the management of chronic pain and to investigate how 
      preferences differ among respondents.
CI  - (c) 2021 Pfizer Inc. European Journal of Pain published by John Wiley & Sons Ltd on 
      behalf of European Pain Federation - EFIC(R).
FAU - Walsh, David A
AU  - Walsh DA
AD  - Pain Centre Versus Arthritis and NIHR Nottingham BRC, Academic Rheumatology, 
      University of Nottingham, Nottingham, UK.
FAU - Boeri, Marco
AU  - Boeri M
AD  - Health Preference Assessment, RTI Health Solutions, Belfast, UK.
AD  - Queen's University of Belfast, Belfast, UK.
FAU - Abraham, Lucy
AU  - Abraham L
AD  - Health Economics and Outcomes Research, Pfizer, Ltd, Surrey, UK.
FAU - Atkinson, Jo
AU  - Atkinson J
AD  - Pfizer, Ltd, Surrey, UK.
FAU - Bushmakin, Andrew G
AU  - Bushmakin AG
AD  - Statistics, Pfizer, Inc, Groton, Connecticut, USA.
FAU - Cappelleri, Joseph C
AU  - Cappelleri JC
AD  - Statistics, Pfizer, Inc, Groton, Connecticut, USA.
FAU - Hauber, Brett
AU  - Hauber B
AD  - Worldwide Medical and Safety, Pfizer, Inc, Collegeville, Pennsylvania, United 
      States.
FAU - Klein, Kathleen
AU  - Klein K
AD  - Health Preference Assessment, RTI Health Solutions, Research Triangle Park, North 
      Carolina, USA.
FAU - Russo, Leo
AU  - Russo L
AD  - Worldwide Medical and Safety, Pfizer, Inc, Collegeville, Pennsylvania, United 
      States.
FAU - Viktrup, Lars
AU  - Viktrup L
AD  - Eli Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, 
      USA.
FAU - Turk, Dennis
AU  - Turk D
AD  - Department of Anesthesiology and Pain Research, University of Washington, 
      Seattle, Washington, USA.
LA  - eng
GR  - MC_PC_19095/MRC_/Medical Research Council/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220108
PL  - England
TA  - Eur J Pain
JT  - European journal of pain (London, England)
JID - 9801774
SB  - IM
MH  - Adult
MH  - Choice Behavior
MH  - *Chronic Pain/drug therapy
MH  - Humans
MH  - Latent Class Analysis
MH  - *Low Back Pain/drug therapy
MH  - Patient Preference
PMC - PMC9303786
COIS- Lucy Abraham, Jo Atkinson, Andrew Bushmakin, Joseph Cappelleri, Brett Hauber and 
      Leo Russo are employees of and hold stock and/or stock options in Pfizer Inc. 
      Lars Viktrup is an employee of Eli Lilly and Company and holds stock. Marco Boeri 
      and Kathleen Klein are employees of RTI Health Solutions, who were paid 
      consultants to Pfizer in connection with the development of this manuscript. In 
      the past 36 months, Dennis C. Turk has received research grants and contracts 
      from the US Food and Drug Administration and US National Institutes of Health and 
      has received compensation for consulting on clinical trials and patient 
      preferences from AccelRx, Eli Lilly and Company, Flexion, GlaxoSmithKline, Pfizer 
      and Swing Therapeutics. Professor Walsh declares a personal financial interest in 
      his employment by the University of Nottingham who received funding for his 
      salary from the UK Government, Sherwood Forest Hospitals NHS Foundation Trust and 
      UKRI. In the past 36 months David Walsh declares the following non-personal 
      financial interests: consultancy through his employment with the University of 
      Nottingham to Pfizer Ltd, Eli Lilly, AbbVie Ltd, Galapagos and Reckitt Benckiser 
      Health Ltd and GlaxoSmithKline Plc, and responsibilities for investigator-led 
      grants outside the work in this manuscript held by the University of Nottingham 
      from Pfizer Ltd and Eli Lilly and Company.
EDAT- 2021/12/03 06:00
MHDA- 2022/03/05 06:00
PMCR- 2022/07/22
CRDT- 2021/12/02 06:54
PHST- 2021/12/03 06:00 [pubmed]
PHST- 2022/03/05 06:00 [medline]
PHST- 2021/12/02 06:54 [entrez]
PHST- 2022/07/22 00:00 [pmc-release]
AID - EJP1892 [pii]
AID - 10.1002/ejp.1892 [doi]
PST - ppublish
SO  - Eur J Pain. 2022 Mar;26(3):648-667. doi: 10.1002/ejp.1892. Epub 2022 Jan 8.