Patient Preference and Adherence (Oct 2023)
Prioritizing Treatment Goals of People Diagnosed with Bipolar I Disorder in the US: Best–Worst Scaling Results
Abstract
John FP Bridges,1,* Joseph F Goldberg,2,* Heather M Fitzgerald,3,* Sanjeda R Chumki,4,* Kathleen Beusterien,5,* Oliver Will,5,* Leslie Citrome6,* 1Department of Biomedical Informatics, the Ohio State University College of Medicine, Columbus, OH, USA; 2Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; 3Medical Affairs, Lundbeck LLC, Deerfield, IL, USA; 4Medical Affairs, Otsuka Pharmaceutical Development & Commercialization Inc, Princeton, NJ, USA; 5Cerner Enviza, North Kansas City, MO, USA; 6Department of Psychiatry & Behavioral Sciences, New York Medical College, Valhalla, NY, USA*These authors contributed equally to this workCorrespondence: Sanjeda R Chumki, Otsuka Pharmaceutical Development & Commercialization Inc, 508 Carnegie Center Dr, Princeton, NJ, 08540, USA, Tel +1-609-524-6788, Email [email protected]: Bipolar I disorder (BP-I) is associated with significant disease burden, but evidence on treatment goals in people diagnosed with BP-I is scarce. This study sought to quantify treatment goals related to the pharmacological management of BP-I in adults in the US and to identify if subgroups of people with similar treatment goals exist.Patients and Methods: A best–worst scaling (BWS) of treatment goals was developed based on available literature and input from experts and patients and was distributed as part of a survey between August and September 2021. Survey participants were adults with a self-reported diagnosis of BP-I who were recruited via an online panel in the US. Participants were asked to prioritize the importance of 16 treatment goals using BWS. BWS scores were computed using multinomial logistic regression, with the scores across all goals summing to 100 for each participant. Subgroups of people with similar preferences were identified using latent class analysis.Results: The most important treatment goals for people diagnosed with BP-I (N=255) were “being less impulsive, angry, or irritable” (score: 9.73), or being “able to feel pleasure or happiness” (score: 9.54). Goals related to reducing the incidence of various potential adverse events of medication (scores: ≤ 4.51) or “reducing dependence on others” (score: 3.04) were less important. Two subgroups were identified. One subgroup (n=111) prioritized symptom-focused goals, considering “reducing frequency of mania, depression, and mixed episodes” and “being less impulsive, angry or irritable” the most important (scores: 12.46 and 11.85, respectively). The other subgroup (n=144) placed significantly more importance on social functioning-focused goals, including beginning or maintaining a relationship with a partner/significant other, and with family and/or friends (scores: 8.45 and 7.70, respectively).Conclusion: People diagnosed with BP-I prioritized emotional improvements. Subgroups of people with BP-I prioritized either symptom-focused or social functioning-focused treatment goals.Keywords: patient preference, healthcare questionnaire, treatment individualization, social functioning
