A discrete-choice experiment to assess patients' preferences for osteoarthritis treatment: An ESCEO working group

Mickael Hiligsmann; Elaine Dennison; Charlotte Beaudart; Gabriel Herrero-Beaumont; Jaime Branco; Olivier Bruyère; Philip G Conaghan; Cyrus Cooper; Nasser Al-Daghri; Famida Jiwa; Willem Lems; Daniel Pinto; Rene Rizzoli; Thierry Thomas; Daniel Uebelhart; Nicolas Veronese; Jean-Yves Reginster

doi:10.1016/j.semarthrit.2020.08.005

A discrete-choice experiment to assess patients' preferences for osteoarthritis treatment: An ESCEO working group

Semin Arthritis Rheum. 2020 Oct;50(5):859-866. doi: 10.1016/j.semarthrit.2020.08.005. Epub 2020 Aug 8.

Authors

Mickael Hiligsmann¹, Elaine Dennison², Charlotte Beaudart³, Gabriel Herrero-Beaumont⁴, Jaime Branco⁵, Olivier Bruyère⁶, Philip G Conaghan⁷, Cyrus Cooper⁸, Nasser Al-Daghri⁹, Famida Jiwa¹⁰, Willem Lems¹¹, Daniel Pinto¹², Rene Rizzoli¹³, Thierry Thomas¹⁴, Daniel Uebelhart¹⁵, Nicolas Veronese¹⁶, Jean-Yves Reginster¹⁷

Affiliations

¹ Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, P.O. Box 616, 6200, MD, The Netherlands. Electronic address: m.hiligsmann@maastrichtuniversity.nl.
² MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
³ Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium; WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Aging, Liège, Belgium.
⁴ Head of Rheumatology Department, IIS-Fundacion Jimenez Diaz, UAM, Madrid, Spain.
⁵ Rheumatology Department, CEDOC-NOVA Medical School, Faculdade de Ciências Médicas da Universidade Nova de Lisboa, CHLO, Hospital Egas Moniz, Lisbon, Portugal.
⁶ MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.
⁷ Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds, UK.
⁸ MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK.
⁹ Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, KSA.
¹⁰ Chair of the Committee of Patients Societies at the International Osteoporosis Foundation, Osteoporosis Canada, Toronto, Canada.
¹¹ Department of Rheumatology, Amsterdam University Medical Center, location VU University Medical Center, Amsterdam, The Netherlands.
¹² Department of Physical Therapy, Marquette University, Milwaukee, USA.
¹³ Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Switzerland.
¹⁴ Department of Rheumatology, Hôpital Nord, CHU Saint-Etienne, Saint-Etienne and INSERM U1059, Université de Lyon-Université Jean Monnet, Saint-Etienne, France.
¹⁵ Division of Musculoskeletal, Internal Medicine and Oncological Rehabilitation, Department of Orthopaedics and Traumatology, Hôpital du Valais (HVS), Centre Hospitalier du Valais Romand (CHVR), CVP, 3963 Crans-Montana, Switzerland.
¹⁶ Neuroscience Institute, Aging Branch, National Research Council, Padua, Italy; Azienda ULSS 3 Serenissima, Primary Care Department, District 3, Venice, Italy.
¹⁷ Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium; WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Aging, Liège, Belgium; Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, KSA.

PMID: 32896701
DOI: 10.1016/j.semarthrit.2020.08.005

Abstract

Objective: To evaluate the preferences of patients with osteoarthritis for treatment.

Methods: A discrete-choice experiment was conducted among adult OA patients who were presented with 12 choice sets of two treatment options and asked in each to select the treatment they would prefer. Based on literature reviews, expert consultation, patient survey and expert meeting, treatment options were characterized by seven attributes: improvement in pain, improvement in walking, ability to manage domestic activities, ability to manage social activities, improvement in overall energy and well-being, risk of moderate/severe side effects and impact on disease progression. Random parameters logit model was used to estimate patients' preferences and a latent class model was conducted to explore preferences classes.

Results: 253 OA patients from seven European countries were included (74% women; mean age 71.3 years). For all seven treatment attributes, significant differences were observed between levels. Given the range of levels of each attribute, the most important treatment attribute in this group was impact on disease progression (29.5%) followed by walking improvement (17.1%) and pain improvement (16.3%). The latent class model identified two preference classes. In the first class (probability of 56%), patients valued impact of disease progression the most (39%). In the second class, walking improvement and improvement in overall energy and well-being were the most important (23%).

Conclusion: This study suggests that all seven treatment attributes were important for OA patients. Overall, given the range of levels, the most important outcomes were impact on disease progression and improvement in pain and walking.

Keywords: Discrete-choice experiment; Osteoarthritis; Outcomes; Patient preferences.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Europe
Female
Humans
Logistic Models
Male
Osteoarthritis* / therapy
Patient Preference*
Surveys and Questionnaires

Abstract

Publication types

MeSH terms

Grants and funding