Patient Preference and Adherence (Sep 2022)
Dynamics of Patient-Based Benefit-Risk Assessment of Medicines in Chronic Diseases: A Systematic Review
Abstract
Hiba EL Masri,1 Treasure M McGuire,1– 3 Mieke L van Driel,4 Helen Benham,5,6 Samantha A Hollingworth1 1School of Pharmacy, The University of Queensland, Brisbane, Queensland, Australia; 2Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia; 3Mater Pharmacy, Mater Health, Brisbane, Queensland, Australia; 4Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, Australia; 5Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia; 6Department of Rheumatology, Princess Alexandra Hospital, Brisbane, Queensland, AustraliaCorrespondence: Hiba EL Masri, School of Pharmacy, The University of Queensland, 20 Cornwall St, Woolloongabba, Brisbane, Queensland, 4102, Australia, Tel +61 478512234, Email [email protected]: A critical gap exits in understanding the dynamics of patient-based benefit-risk assessment (BRA) of medicines in chronic diseases during the disease journey.Purpose: To systematically review and synthesize current evidence on the changes of patients’ preferences about the benefits and risks of medicines during their disease journey including the influence of disease duration and severity, and previous treatment experience.Methods: A systematic review of studies identified in PubMed and Embase, from inception to November 2020, was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Articles were eligible if they analyzed adult patient-based BRA of medicines with a chronic disease, based on at least one of the pre-specified dimensions: disease severity, disease duration, or previous treatment experience.Results: A total of 26,228 articles were identified and 105 were eligible for inclusion. Of these, 85 detected a variation in patient-based BRA of medicines with at least one of the pre-specified criteria. Patients with higher disease severity and more treatment experience have increased risk tolerance. It remains inconclusive whether disease duration directly affects the relative importance of a patient’s preference.Conclusion: Factors important for patients’ BRA of their medicines during a chronic disease journey vary more with their clinical situation and previous treatment experience than with time since diagnosis. Due to the importance of these factors on patients’ perspectives and potential impact on their decision-making and eventually their clinical outcomes, there is a need for more studies to assess the dynamics of patients’ BRA in every disease.Keywords: patient preference, choice behavior, decision making, health knowledge, attitudes, practice, attributes, risk tolerance
