A Review of Patient Preferences for Osteoporosis D

Authors: Mickaël Hiligsmann Sandrine P G Bours Annelies Boonen

Publish Date: 2015/08/19

Volume: 17, Issue: 9, Pages: 61-

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Abstract

Poor medication adherence is a major problem in chronic diseases such as osteoporosis that may partially be due to unaddressed patient values and preferences Data on patient preferences could help clinicians to improve medication adherence and could also be useful in policy decisions and guideline development This paper aims to identify literature reporting on the preferences of patients for osteoporosis drug medications Several methods have been used to elicit patient preferences for medications and their characteristics including qualitative research survey with ranking/rating exercises discretechoice experiments and clinical studies crossover designs openlabel study All these studies revealed that osteoporotic patients have preferences for medications and their attributes in particular for lessfrequent dosing regimens Interestingly variations in the preferences of patients were observed in most studies suggesting the importance to take into account individual preference in decisionmaking to improve osteoporosis careOsteoporosis represents an increasing public health problem especially in the Western world For the year 2010 it was estimated that about 275 million of people from the European Union have osteoporosis 1 resulting in approximately 35 million new fractures Despite the fact that several drugs have demonstrated to be safe and effective in reducing the risk of fractures 2 adherence to medications remains poor and suboptimal 3 with substantial clinical and economic implications 4 Poor adherence to therapy may partially be due to unaddressed patient values and preferences 5Understanding what patients prefer and involving them in clinical decisionmaking could lead to improved satisfaction with therapy and hence medication adherence 6 Patient perceptions and preferences with osteoporosis medications were shown to impact adherence behaviour 7•• and discontinuation rates 8 The patient’s perspective is now becoming increasingly important in the design and assessment of healthcare interventions 9 Patients want to be informed by their doctors and play an active role in clinical decisionmaking 10 Therefore in recent years there has been a growing interest in studies to elicit preferences for healthcare interventions There are different ways to elicit patient preferences including qualitative research survey with ranking/rating exercises discretechoice experiments and clinical studies such as crossover or openlabel studyWith the development of new osteoporosis medications that differ mainly according to mode of administration it is not surprising that several studies have been conducted to elicit patient preferences for osteoporosis medications and understand the socalled attributes or factors that contribute to preferences Reviewing these studies and reporting their findings could have substantial potential for clinicians towards improving poor medication adherence and could also be very useful for policy decisions and guideline development 11 This paper was therefore designed to review studies that assessed preferences in osteoporosis A secondary aim was to discuss how preference could be incorporated in clinical decisionmakingA review of published studies that describe patient preferences for osteoporosis drug treatment was conducted in PubMed The search terms were ‘preference title/abstract OR satisfaction title/abstract AND ‘osteoporosis MESH term’ and all articles published until May 1 2015 were included We only included original research that looks at preferences for osteoporosis medications and/or medication attributes We followed the operational definition of preference given by Joy et al 11 ‘given a choice the selection of an alternative’ We therefore included studies that looked at the choice of patient between alternatives We also included preference studies that assessed preferences for medication attributes using hypothetical treatment options and studies that were interested in preferences for medication characteristics Nonmedication interventions were excluded Abstract and title screening was initially performed followed by a fulltext screening References of identified articles were searched for additional articles and completed by authors’ knowledge of the published literature Data were collected on study authors country publication year method sample size funding and main findings The number of medication attributes was included for surveys and interventions were included for clinical studies

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