Preferences for medication attributes among patients with type 2 diabetes mellitus in the UK

Diabetes Obes Metab. 2013 Sep;15(9):802-9. doi: 10.1111/dom.12091. Epub 2013 Apr 7.

Abstract

Aim: To examine preferences for oral medication attributes among participants with early and advanced type 2 diabetes mellitus (T2DM) in the UK using a discrete choice experiment (DCE).

Methods: A web-based DCE was administered where participants indicated which medication they preferred from two different hypothetical oral anti-diabetic (OAD) medication profiles, each composed of differing levels of seven attributes (efficacy, hypoglycaemic events, weight change, gastrointestinal/nausea side effects, urinary tract infection and genital infection, blood pressure and cardiovascular risk) for 20 sets of pair-wise comparisons. A random effects multinomial logit regression model was used to estimate the preference weight (PW) for each of the attribute levels, and the relative importance (RI) of each attribute was calculated. Analyses were conducted for the overall sample and for medication and gender subgroups.

Results: The final sample included 100 participants with a mean age of 62.9 (SD 11.1) years and comparable numbers of participants of each gender (51% male, 49% female). The majority of the participants were White-British (92%). The total PW and corresponding RI were highest for four of the seven attributes: hypoglycaemic events (PW = 1.98; RI = 24.7%), weight change (PW = 1.65; RI = 20.6%), gastrointestinal/nausea side effects (PW = 1.49; RI = 18.6%) and efficacy (PW = 1.44; RI = 18.0%). The RI values differed for some attributes across gender and number of current T2DM medication subgroups.

Conclusion: The results suggest that hypoglycaemia, weight change, gastrointestinal side effects and efficacy are of primary importance to patients in their OAD preferences in T2DM. These four attributes comprised over 80% of the RI.

Keywords: discrete choice experiment; patient preference; type 2 diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adult
  • Cardiovascular Diseases / chemically induced*
  • Cardiovascular Diseases / psychology
  • Choice Behavior*
  • Decision Making
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / psychology
  • Female
  • Gastrointestinal Diseases / chemically induced*
  • Gastrointestinal Diseases / psychology
  • Humans
  • Hypoglycemia / chemically induced*
  • Hypoglycemia / psychology
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use*
  • Internet
  • Logistic Models
  • Male
  • Medication Adherence
  • Middle Aged
  • Patient Preference*
  • Pilot Projects
  • Risk Factors
  • Surveys and Questionnaires
  • United Kingdom / epidemiology
  • Weight Gain / drug effects
  • Weight Loss / drug effects

Substances

  • Hypoglycemic Agents