TY - JOUR
T1 - Education and patient preferences for treating type 2 diabetes
T2 - A stratified discrete-choice experiment
AU - Janssen, Ellen M.
AU - Longo, Daniel R.
AU - Bardsley, Joan K.
AU - Bridges, John F.P.
N1 - Funding Information:
The authors sincerely thank the Johns Hopkins Institute for Clinical and Translational Research (ICTR) Community Research Advisory Council (C-RAC) and members of the Diabetes Action Board (DAB) for their valuable contributions and engagement in the research study. This work was supported by a Patient-Centered Outcomes Research Institute (PCORI) Methods Award (ME-1303-5946) and by the Center for Excellence in Regulatory Science and Innovation (CERSI) (1U01FD004977-01). The funders had no role in the design and conduct of the study, interpretation of the data, or preparation of the manuscript.
Publisher Copyright:
© 2017 Janssen et al.
PY - 2017/10/6
Y1 - 2017/10/6
N2 - Purpose: Diabetes is a chronic condition that is more prevalent among people with lower educational attainment. This study assessed the treatment preferences of patients with type 2 diabetes by educational attainment. Methods: Patients with type 2 diabetes were recruited from a national online panel in the US. Treatment preferences were assessed using a discrete-choice experiment. Participants completed 16 choice tasks in which they compared pairs of treatment profiles composed of six attributes: A1c decrease, stable blood glucose, low blood glucose, nausea, treatment burden, and out-of-pocket cost. Choice models and willingness-to-pay (WTP) estimates were estimated using a conditional logit model and were stratified by educational status. Results: A total of 231 participants with a high school diploma or less education, 156 participants with some college education, and 165 participants with a college degree or more completed the survey. Participants with a college degree or more education were willing to pay more for A1c decreases ($58.84, standard error [SE]: 10.6) than participants who had completed some college ($28.47, SE: 5.53) or high school or less ($17.56, SE: 3.55) (p≤0.01). People with a college education were willing to pay more than people with high school or less to avoid nausea, low blood glucose events during the day/night, or two pills per day. Conclusion: WTP for aspects of diabetes medication differed for people with a college education or more and a high school education or less. Advanced statistical methods might overcome limitations of stratification and advance understanding of preference heterogeneity for use in patient-centered benefit-risk assessments and personalized care approaches.
AB - Purpose: Diabetes is a chronic condition that is more prevalent among people with lower educational attainment. This study assessed the treatment preferences of patients with type 2 diabetes by educational attainment. Methods: Patients with type 2 diabetes were recruited from a national online panel in the US. Treatment preferences were assessed using a discrete-choice experiment. Participants completed 16 choice tasks in which they compared pairs of treatment profiles composed of six attributes: A1c decrease, stable blood glucose, low blood glucose, nausea, treatment burden, and out-of-pocket cost. Choice models and willingness-to-pay (WTP) estimates were estimated using a conditional logit model and were stratified by educational status. Results: A total of 231 participants with a high school diploma or less education, 156 participants with some college education, and 165 participants with a college degree or more completed the survey. Participants with a college degree or more education were willing to pay more for A1c decreases ($58.84, standard error [SE]: 10.6) than participants who had completed some college ($28.47, SE: 5.53) or high school or less ($17.56, SE: 3.55) (p≤0.01). People with a college education were willing to pay more than people with high school or less to avoid nausea, low blood glucose events during the day/night, or two pills per day. Conclusion: WTP for aspects of diabetes medication differed for people with a college education or more and a high school education or less. Advanced statistical methods might overcome limitations of stratification and advance understanding of preference heterogeneity for use in patient-centered benefit-risk assessments and personalized care approaches.
KW - Choice experiment
KW - Educational attainment
KW - Preference heterogeneity
KW - Preference heterogeneity
KW - Stated-preference methods
KW - Willingness-to-pay
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U2 - 10.2147/PPA.S139471
DO - 10.2147/PPA.S139471
M3 - Article
C2 - 29070940
AN - SCOPUS:85031509085
VL - 11
SP - 1729
EP - 1736
JO - Patient Preference and Adherence
JF - Patient Preference and Adherence
SN - 1177-889X
ER -