Patient Preference and Adherence (Jul 2024)
Physician and Patient Preferences for Treatment of Anemia Associated with Chronic Kidney Disease in Japan: A Survey Including Best-Worst Scaling
Abstract
Sari Mishina,1 Yuichiro Ito,1 Takumi Lee,1 Toshiaki Murofushi,2 Yoshiyuki Uetake,2 Tadao Akizawa3 1Astellas Pharma Inc, Tokyo, Japan; 2INTAGE Healthcare Inc, Tokyo, Japan; 3Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, JapanCorrespondence: Sari Mishina, Astellas Pharma Inc, 2-5-1, Nihonbashi-Honcho, Chuo-ku, Tokyo, Japan, Tel +81-3-3244-0294, Email [email protected]: Several treatment options are available for anemia associated with chronic kidney disease (CKD); however, there remains a lack of awareness of physician and patient preferences regarding these treatments. We aimed to explore physicians’ and patients’ perceptions and preferences regarding the management of anemia of CKD in Japan.Methods: A web-based survey, including best-worst scaling (BWS), was conducted with physicians who had treated ≥ 1 patient with anemia of CKD in the preceding year, and with patients with CKD who self-reported a clinical diagnosis of anemia of CKD or low hemoglobin levels. A three-step approach was used comprising cognitive interviews, a pilot survey, and a main survey. The BWS survey results were analyzed using multinomial logit and hierarchical Bayesian models.Results: The survey was completed by 906 participants: 103 patients (average age 60.6 years; 77.7% male) and 803 physicians (166 nephrologists, 214 cardiologists, 137 diabetologists, and 286 general internists). Almost all (96.0%) physicians surveyed considered anemia of CKD to be an important condition to treat. Hypoxia-inducible factor prolyl hydroxylase (HIF-PH) inhibitors had the highest treatment satisfaction among physicians, whereas patients had the highest satisfaction with both erythropoietin-stimulating agent therapy and HIF-PH inhibitors. Approximately one-third (35.9%) of patients surveyed indicated that they were receiving treatment. When comparing the relative importance of attributes and levels, physicians favored efficacy (particularly improvement in hemoglobin levels), whereas patients favored safety (particularly a lower rate of severe adverse events).Conclusion: Although a majority of physicians consider treatment of CKD-related anemia important, differences in the perceptions and usage of medications exist between medical specialties. Preferences for the management of anemia of CKD vary between physicians and patients; therefore, patient involvement in treatment decisions may help optimize outcomes.Keywords: anemia, best-worst scaling, chronic kidney disease, erythropoiesis-stimulating agents, hypoxia-inducible factor prolyl hydroxylase inhibitors, treatment preference
