Presentation (CTI)

OBJECTIVES: With the increasing focus on including patient preferences (PP) in benefit-risk analyses, there is a need to understand whether, and how, prior experience with an adverse event (AE) impacts PP. We aimed to systematically identify, and summarize, studies exploring the relationship between experience of specific AEs and PP.
METHODS: A systematic literature review was conducted by initially searching PubMed in January 2023 for papers published prior to December 31, 2022. Peer-reviewed papers in English on stated preference (e.g., discrete choice experiments, best-worst scaling, threshold technique) studies in health were included. Studies were included if they examined PP for AEs and previous experience with the AEs. We extracted data on publication characteristics, AE attributes, demographics, question formats, preference heterogeneity, and direction of effect.
RESULTS: The search identified 864 potential titles and abstracts. Of those 79 were included for a full-text review; data were extracted from 25 papers, mostly published in the past 10 years, with 6 published in 2020. Although results from 5 different methods were reported, 21 papers used discrete choice experiments. The most common methods for testing for experience-based heterogeneity in preferences were subgroup analysis (n=9) and latent class analysis (n=11). The results on the impact of AE experience on PP were mixed: 7 studies found that prior experience increased risk aversion, 3 studies found decreased risk aversion, 8 studies found no significant effect and 7 studies tested but did not present quantitative results in the paper.
CONCLUSIONS: This review provides evidence that the effect of experience of AE on preferences is mixed and remains an empirical question. The findings suggest that more evidence is needed and standardized approaches to measure and report how AE experience impacts on PP would be beneficial to better inform benefit-risk assessments and patient-centered drug development.