“What matters to people with severe asthma? Exploring add-on asthma medication and outcomes of importance”
- 1National Health and Medical Research Council Centre for Research Excellence in Severe Asthma and The Priority Research Centre for Healthy Lungs, The University of Newcastle, Callaghan, NSW, Australia
- 2School of Nursing and Midwifery, The University of Newcastle, Callaghan, NSW, Australia
- 3Department of Respiratory and Sleep Medicine, John Hunter Hospital, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Prof. Vanessa McDonald. E-mail: Vanessa.McDonald{at}newcastle.edu.au
Abstract
Introduction There is an increasing number of new therapies for severe asthma, however what outcomes people with severe asthma would like improved and what aspects they prioritise in new medications remain unknown. This study aimed to understand what outcomes are important to patients when prescribed new treatments and to determine the characteristics of importance to patients in their choice of asthma treatments.
Methods Participants with severe asthma (n=50) completed a cross-sectional survey that ranked 17 potential hypothetical outcomes of treatment using a seven point Likert scale, as well as selecting their top five overall outcomes. Participants also completed hypothetical scenarios trading off medication characteristics for four hypothetical add-on asthma treatments.
Results Participants (58% male), had a mean (sd) age of 62.2 (13.5) years. Their top three prioritised outcomes were: to improve overall quality-of-life (selected by 83% of people), reduce number and severity of asthma attacks (72.3%), and being able to participate in physical activity (59.6%) When trading off medication characteristics the majority of patients with severe asthma chose the hypothetical medication with the best treatment efficacy (68%). However, a subgroup of patients prioritised the medications side effect profile and mode of delivery to select their preferred medication.
Conclusion People with severe asthma value improved quality-of-life as an important outcome of treatment. Shared decision-making discussions between clinicians and patients that centre around medication efficacy and side effect profile can incorporate patient preferences for add-on therapy in severe asthma.
Footnotes
This manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.
Conflict of interest: Dr. Clark reports grants from National Health and Medical Research Council, during the conduct of the study; personal fees from Astra Zeneca, outside the submitted work.
Conflict of interest: Dr. Gibson reports personal fees from AstraZeneca, GlaxoSmithKline, Novartis, grants from AstraZeneca, GlaxoSmithKline, outside the submitted work.
Conflict of interest: Dr. McDonald reports grants from National Health and Medical Research Council, during the conduct of the study; grants from Hunter Medical Research Institute, grants from National Health and Medical Research Council, grants from John Hunter Hospital Charitable Trust Research, grants and personal fees from GSK, grants and personal fees from Menarini, grants and personal fees from Astra Zeneca, outside the submitted work.
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- Received July 15, 2020.
- Accepted November 8, 2020.
- Copyright ©ERS 2020
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