Patient preferences for treatment in type 2 diabetes: the Italian discrete-choice experiment analysis.

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  • Additional Information
    • Source:
      Publisher: Springer Verlag Country of Publication: Germany NLM ID: 9200299 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-5233 (Electronic) Linking ISSN: 09405429 NLM ISO Abbreviation: Acta Diabetol Subsets: MEDLINE
    • Publication Information:
      Publication: Berlin : Springer Verlag
      Original Publication: Berlin : Springer International, c1991-
    • Subject Terms:
      Dosage Forms*; Diabetes Mellitus, Type 2/*drug therapy ; Diabetes Mellitus, Type 2/*epidemiology ; Hypoglycemic Agents/*administration & dosage ; Patient Preference/*statistics & numerical data; Aged ; Body Weight/drug effects ; Choice Behavior ; Dose-Response Relationship, Drug ; Drug Administration Routes ; Drug Administration Schedule ; Female ; Glucagon-Like Peptide-1 Receptor/agonists ; Humans ; Hypoglycemic Agents/adverse effects ; Hypoglycemic Agents/classification ; Italy/epidemiology ; Male ; Middle Aged ; Surveys and Questionnaires ; Weight Loss/drug effects
    • Abstract:
      Aims: Several drug classes are now available to achieve a satisfactory metabolic control in patients with type 2 diabetes (T2DM), but patients' preferences may differ.
      Methods: In a discrete-choice experiment, we tested T2DM patients' preferences for recent antidiabetic drugs, in the event that their treatment might require intensification. The following attributes were considered: (a) route of administration; (b) type of delivery; (c) timing; (d) risk of adverse events; (e) effects on body weight. Twenty-two possible scenarios were built, transferred into 192 paired choices and proposed to 491 cases naïve to injectable treatments and 171 treated by GLP-1 receptor agonists (GLP-1RAs). Analyses were performed by descriptive statistics and random effects logit regression model.
      Results: Preferences according to dosing frequency, risk of nausea and urinary tract infections (UTls) were similar across groups, age, sex and BMI. Administration route and delivery type accounted for 1/3 of relative importance; the risk of UTIs, nausea and dosing frequency for ≈ 20% each, and weight loss for only 6%. Two significant interactions emerged (p < 0.01): type of delivery × group, and weight change × BMI class. Irrespective of previous treatment, the three preferred choices were injectable, coupled with weekly dosing and a ready-to-use device (first two choices). In a regression model, being naïve or non-naïve changed the ranking of preferences (p < 0.001), and the order was systematically shifted towards injectable medications in non-naïve subjects.
      Conclusion: Easy-to-deliver, injectable treatment is preferred in T2DM, independently of treatment history, and previous experience with GLP-1RAs strengthens patients' willingness to accept injectable drugs.
    • Contributed Indexing:
      Keywords: Adverse events; Dose frequency; Glucagon-like peptide-1 receptor agonists; Injectable drugs; Nausea; Oral treatment; Route of delivery; Sodium–glucose co-transporter 2 inhibitors; Urogenital-tract infections; Weight loss
    • Accession Number:
      0 (Dosage Forms)
      0 (Glucagon-Like Peptide-1 Receptor)
      0 (Hypoglycemic Agents)
    • Publication Date:
      Date Created: 20181012 Date Completed: 20190415 Latest Revision: 20190415
    • Publication Date:
      20231215
    • Accession Number:
      10.1007/s00592-018-1236-6
    • Accession Number:
      30306406