IDEAS home Printed from https://ideas.repec.org/a/spr/patien/v14y2021i2d10.1007_s40271-020-00454-3.html
   My bibliography  Save this article

High-Efficacy Disease-Modifying Therapies in People with Relapsing–Remitting Multiple Sclerosis: The Role of Risk Attitude in Treatment Decisions

Author

Listed:
  • Jorge Maurino

    (Roche Farma)

  • Javier Sotoca

    (Hospital Universitari Mútua de Terrassa)

  • Ángel P. Sempere

    (Hospital General Universitario de Alicante)

  • Luis Brieva

    (Hospital Universitari Arnau de Vilanova)

  • Carlos López de Silanes

    (Hospital Universitario de Torrejón)

  • Ana B. Caminero

    (Complejo Asistencial de Ávila)

  • María Terzaghi

    (University of Toronto)

  • Julia Gracia-Gil

    (Complejo Hospitalario Universitario de Albacete)

  • Gustavo Saposnik

    (University of Toronto
    University of Toronto
    University of Zurich)

Abstract

Background Risk attitude is defined as the willingness to tolerate risk to achieve a greater expected return. Limited information is available on how relapsing–remitting multiple sclerosis people’s perceptions about disease trajectory and risk attitude may influence treatment choices. Methods A non-interventional study applying principles of behavioral economics was conducted to assess willingness to receive unwarranted high-efficacy disease-modifying therapy (DMT) according to best-practice guidelines. People with relapsing–remitting multiple sclerosis (PwRRMS) according to 2010 McDonald criteria completed a survey on symptom severity, risk preferences, and management of simulated case scenarios mimicking the current treatment landscape. PwRRMS’s choice for high-efficacy agents was established as the participant’s selection of monoclonal antibodies for case scenarios with at least 2 years of clinical and radiological stability. Results A total of 211 PwRRMS were studied (mean age 39.1 ± 9.5 years, 70.1% female, mean Expanded Disability Status Scale score 1.8 ± 1.1). Almost 50% (n = 96) opted for a high-efficacy DMT despite the lack of evidence of disease activity. Younger age and risk-seeking behavior were associated with an increased likelihood of selecting unwarranted high-efficacy DMT [odds ratio (OR) 2.00, 95% confidence interval (CI) 1.02–3.93, p = 0.043, and OR 2.17, 95% CI 1.09–4.30, p = 0.027, respectively]. Clinical characteristics or subjective perception of symptom severity had no influence on participants’ treatment choices. Conclusion Identifying PwRRMS with risk-seeking behavior would be crucial to implementing specific educational strategies to manage information on disease prognosis, treatment expectations, and safety risk knowledge.

Suggested Citation

  • Jorge Maurino & Javier Sotoca & Ángel P. Sempere & Luis Brieva & Carlos López de Silanes & Ana B. Caminero & María Terzaghi & Julia Gracia-Gil & Gustavo Saposnik, 2021. "High-Efficacy Disease-Modifying Therapies in People with Relapsing–Remitting Multiple Sclerosis: The Role of Risk Attitude in Treatment Decisions," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 14(2), pages 241-248, March.
    • Handle: RePEc:spr:patien:v:14:y:2021:i:2:d:10.1007_s40271-020-00454-3
    DOI: 10.1007/s40271-020-00454-3
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s40271-020-00454-3
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.
    File URL: https://libkey.io/10.1007/s40271-020-00454-3?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Caroline Vass & Dan Rigby & Katherine Payne, 2019. "“I Was Trying to Do the Maths”: Exploring the Impact of Risk Communication in Discrete Choice Experiments," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 12(1), pages 113-123, February.
    2. Julia Krämer & Jan-Gerd Tenberge & Ingo Kleiter & Wolfgang Gaissmaier & Tobias Ruck & Christoph Heesen & Sven G Meuth, 2017. "Is the risk of progressive multifocal leukoencephalopathy the real reason for natalizumab discontinuation in patients with multiple sclerosis?," PLOS ONE, Public Library of Science, vol. 12(4), pages 1-17, April.
    3. Edward J. D. Webb & David Meads & Ieva Eskytė & Helen L. Ford & Hilary L. Bekker & Jeremy Chataway & George Pepper & Joachim Marti & Yasmina Okan & Sue H. Pavitt & Klaus Schmierer & Ana Manzano, 2020. "The Impact of Reproductive Issues on Preferences of Women with Relapsing Multiple Sclerosis for Disease-Modifying Treatments," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 13(5), pages 583-597, October.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Stolk-Vos, Aline C. & Attema, Arthur E. & Manzulli, Michele & van de Klundert, Joris J., 2022. "Do patients and other stakeholders value health service quality equally? A prospect theory based choice experiment in cataract care," Social Science & Medicine, Elsevier, vol. 294(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Caroline M. Vass & Niall J. Davison & Geert Stichele & Katherine Payne, 2020. "A Picture is Worth a Thousand Words: The Role of Survey Training Materials in Stated-Preference Studies," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 13(2), pages 163-173, April.
    2. Hangjian Wu & Emmanouil Mentzakis & Marije Schaafsma, 2022. "Exploring Different Assumptions about Outcome-Related Risk Perceptions in Discrete Choice Experiments," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 81(3), pages 531-572, March.
    3. Caroline M. Vass & Marco Boeri, 2021. "Mobilising the Next Generation of Stated-Preference Studies: the Association of Access Device with Choice Behaviour and Data Quality," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 14(1), pages 55-63, January.
    4. Ingrid E. H. Kremer & Mickael Hiligsmann & Josh Carlson & Marita Zimmermann & Peter J. Jongen & Silvia M. A. A. Evers & Svenja Petersohn & Xavier G. L. V. Pouwels & Nick Bansback, 2020. "Exploring the Cost Effectiveness of Shared Decision Making for Choosing between Disease-Modifying Drugs for Relapsing-Remitting Multiple Sclerosis in the Netherlands: A State Transition Model," Medical Decision Making, , vol. 40(8), pages 1003-1019, November.
    5. Alison Pearce & Mark Harrison & Verity Watson & Deborah J. Street & Kirsten Howard & Nick Bansback & Stirling Bryan, 2021. "Respondent Understanding in Discrete Choice Experiments: A Scoping Review," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 14(1), pages 17-53, January.
    6. Dan Rigby & Caroline Vass & Katherine Payne, 2020. "Opening the ‘Black Box’: An Overview of Methods to Investigate the Decision-Making Process in Choice-Based Surveys," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 13(1), pages 31-41, February.
    7. Vass, Caroline M. & Boeri, Marco & Poulos, Christine & Turner, Alex J., 2022. "Matching and weighting in stated preferences for health care," Journal of choice modelling, Elsevier, vol. 44(C).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:patien:v:14:y:2021:i:2:d:10.1007_s40271-020-00454-3. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.