Patient Preference and Adherence (Oct 2018)
Patients’, physicians’, nurses’, and pharmacists’ preferences on the characteristics of biologic agents used in the treatment of rheumatic diseases
Abstract
Luciana Scalone,1 Piercarlo Sarzi-Puttini,2 Luigi Sinigaglia,3 Carlomaurizio Montecucco,4 Roberto Giacomelli,5 Giovanni Lapadula,6 Ignazio Olivieri,7,8,† Angela Maria Giardino,9 Paolo Angelo Cortesi,1 Lorenzo Giovanni Mantovani,1 Monica Mecchia9On behalf of the CARA Study Group1Centre of Research on Public Health, University of Milano-Bicocca, and CHARTA Foundation, Milan, Italy; 2Rheumatology Unit, L. Sacco University Hospital, 3Rheumatology Unit, G. Pini Hospital, Milan, Italy; 4University of Pavia School of Medicine, IRCCS Policlinico San Matteo Foundation, Pavia, Italy; 5Rheumatology Unit School of Medicine, University of L’Aquila, L’Aquila, Italy; 6Rheumatology Unit, University of Bari, Bari, Italy; 7Rheumatology Department of Lucania, San Carlo Hospital of Potenza, Potenza, Italy; 8Madonna delle Grazie Hospital of Matera, Matera, Italy; 9MSD Italy, Rome, Italy†Dr Ignazio Olivieri passed away on July 28, 2017Objective: To estimate preferences in relevant treatment characteristics evaluated by different groups involved in the management of patients with rheumatic diseases.Subjects and methods: We surveyed patients with rheumatic diseases, and rheumatologists, nurses, and pharmacists with experience in treatment with/provision of biologic drugs for these patients. Through a discrete choice experiment, participants evaluated 16 possible scenarios in which pairs of similarly efficacious treatments were described with six characteristics: 1) frequency of administration; 2) mode and place of administration; 3) manner, helpfulness, efficiency, and courtesy of health personnel; 4) frequency of reactions at the site of drug administration; 5) severity of generalized undesired/allergic reactions; and 6) additional cost. The direction and strength of preferences toward each characteristic level and the relative importance of each characteristic were estimated through a random-effects conditional logistic regression model.Results: In total, 513 patients, 110 rheumatologists, 51 nurses, and 46 pharmacists from 30 centers in Italy participated. Characteristics 3, 4, and 6 were the most important for every subgroup; 1 was least important for patients and rheumatologists, 2 was least important for pharmacists, and 2 and 5 were least important for nurses. For characteristic 2, pharmacists preferred subcutaneous self-injection with a syringe; nurses preferred assisted infusion at an infusion center close to the patient’s home; patients and rheumatologists preferred subcutaneous self-injection with a pen.Conclusion: The different preferences for some characteristics shown by the different groups can play an important role, together with purely clinical aspects, in the choice and consequent benefit of treatments, contributing also to a more satisfactory use of resources.Keywords: preferences, biologic drugs, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, decision making
