PATIENT PREFERENCES IN THE THERAPY OF ADHD - A DISCRETE CHOICE EXPERIMENT
Author(s)
Axel Christian Mühlbacher, Professor, Dr, Geschäftsführer1, Ina Rudolph, Dr, Associate Director, Health Economics & Reimbursement2, Hans-Joachim Lincke, Dr, Senior Researcher1, Matthias Nübling, Dr, Geschäftsführer11Gesellschaft für empirische Beratung mbH, D- 79211 Denzlingen, Germany; 2 Janssen Cilag GmbH, Neuss/Germany, D-41470 Neuss, Germany
Objective: While the clinical efficacy of drugs for ADHD is widely studied in clinical trials (usually randomised controlled trials, RCTs), patient preferences with regard to their treatments are not well understood and therefore considered to a less extent. Aim of this study therefore was to explore the patients' perceptions of an „ideal treatment“ for ADHD. Methods: Examination of the state of the art as reported in the literature was followed by a qualitative study with four focus groups consisting of 6-8 parents of ADHD-patients each. In a subsequent quantitative study phase, data was collected in an online or paper-pencil self-fill-in questionnaire for parents of patients and patient (age >14 years) themselves. It included sociodemographic data, treatment history and actual treatment and patients' preferences of therapy characteristics using direct measurement (23 items on a 5-point Likert-scale) as well as a discrete-choice-experiment (DCE, 8 pairs with 6 characteristics). Results: N=213 questionnaires were filled; most of them by the parents of patients (79% by the mothers, 9% by the fathers). Most of the patients were male (83%) and most of them (83%) had actual medical treatment of ADHD. Direct measurement showed "good emotional quality of live“, "no addiction on medication”, “improvement of concentration capability,” and "few side effects“ in the first places. In the DCE, alternatives with "better social quality of life (friendships etc. possible)“, “better emotional quality of life (disease not all of the time mentally present)”, and "longer duration of medication effect“ were more likely to be chosen, giving thus similar results. Conclusion: This unique study demonstrates that it is possible to obtain valid and robust information from patients on what constitutes relevant patient outcomes. Such information should play a critical role in appraisal of treatment alternatives by HTA bodies.
Conference/Value in Health Info
2008-05, ISPOR 2008, Toronto, Ontario, Canada
Value in Health, Vol. 11, No. 3 (May/June 2008)
Code
PMH61
Topic
Patient-Centered Research
Topic Subcategory
Stated Preference & Patient Satisfaction
Disease
Mental Health