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A Comparison of Caregiver and Patient Preferences for Treating Duchenne Muscular Dystrophy

Author

Listed:
  • Norah L. Crossnohere

    (The Ohio State University College of Medicine)

  • Ryan Fischer

    (Parent Project Muscular Dystrophy)

  • Elizabeth Vroom

    (Duchenne Parent Project)

  • Patricia Furlong

    (Parent Project Muscular Dystrophy)

  • John F. P. Bridges

    (The Ohio State University College of Medicine)

Abstract

Background and Objectives Caregivers routinely inform medical and regulatory decision making in rare pediatric diseases. While differences in treatment preferences across caregivers and patients have been observed for Duchenne muscular dystrophy, this evidence was limited by small samples of patients and results were confounded by patient age and disease progression. We tested caregiver and patient preference concordance for treating Duchenne. Methods Preferences and demographic/clinical information from 115 caregivers and 107 patients were collected in an international study (response = 80%) using a previously developed discrete-choice experiment consisting of 12 experimentally controlled choice tasks. Each task presented two profiles that varied across four attributes: disease progression, drug failure probability, kidney damage risk, and fracture risk. Caregivers and patients were matched 1:1 based on patient age. We tested for concordance across each task and by comparing caregivers’ and patients’ maximum acceptable risk of drug failure, kidney damage, and fracture for a slowing of disease progression. Results The final analysis included 77 caregivers and 77 patients. No differences were observed in nationality (p = 0.969), disease stage (p = 0.180), or demographic/clinical factors (p = 0.093–0.857); however, patients were more optimistic (p = 0.030). Caregivers and patients chose similarly across tasks (p = 0.101–0.993). To slow disease progression by 1 year, caregivers and patients would tolerate a 9% and 11% increase in drug failure probability, respectively (p = 0.267). Alternatively, they would accept a 3% and 4% increase in the risk of kidney damage (p = 0.719) or a 15% and 20% increase in the risk of fracture (p = 0.534). Conclusions Caregivers and patients had concordant preferences for treating Duchenne. Providers and regulators can trust both caregiver and patient report of preferences to inform medical decision making.

Suggested Citation

  • Norah L. Crossnohere & Ryan Fischer & Elizabeth Vroom & Patricia Furlong & John F. P. Bridges, 2022. "A Comparison of Caregiver and Patient Preferences for Treating Duchenne Muscular Dystrophy," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 15(5), pages 577-588, September.
    • Handle: RePEc:spr:patien:v:15:y:2022:i:5:d:10.1007_s40271-022-00574-y
    DOI: 10.1007/s40271-022-00574-y
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    References listed on IDEAS

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    1. Train,Kenneth E., 2009. "Discrete Choice Methods with Simulation," Cambridge Books, Cambridge University Press, number 9780521766555, September.
    2. A. Brett Hauber & Angelyn Fairchild & F. Reed Johnson, 2013. "Quantifying Benefit–Risk Preferences for Medical Interventions: An Overview of a Growing Empirical Literature," Applied Health Economics and Health Policy, Springer, vol. 11(4), pages 319-329, August.
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    1. Norah L. Crossnohere & Janet E. Childerhose & Seuli Bose-Brill, 2022. "Increasing the Patient-Centeredness of Predictive Analytics Tools," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 15(6), pages 615-617, November.

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