People living with Moderate-to-Severe COPD Prefer Improvement of Daily Symptoms Over the Improvement of Exacerbations: A Multi-Country Patient Preference Study
- Nigel S. Cook1,
- Gerard J. Criner2,
- Pierre-Régis Burgel3,4,
- Katie Mycock5,
- Tom Gardner6,14,
- Phil Mellor6,
- Pam Hallworth6,
- Kate Sully7,
- Sophi Tatlock7,
- Beyza Klein1,
- Byron Jones1,
- Olivier Le Rouzic8,9,
- Kip Adams10,
- Kirsten Phillips11,
- Mike McKevitt12,
- Kazuko Toyama13 and
- Florian S. Gutzwiller1⇑
- 1Novartis Pharma AG, Basel, Switzerland
- 2Temple University, Philadelphia, PA, USA
- 3Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
- 4Université de Paris and Institut Cochin, Inserm U1016, Paris, France
- 5Adelphi Real World, Cheshire, UK
- 6Adelphi Research, Cheshire, UK
- 7Adelphi Values, Cheshire, UK
- 8La Fondation du Souffle, Paris, France
- 9Univ. Lille, CHU Lille, Inserm U1019, Lille, France
- 10COPD Foundation, Miami, Florida, USA
- 11Lung Foundation, Australia, Brisbane, Queensland, Australia
- 12British Lung Foundation, England, UK
- 13J-Breath, Tokyo, Japan
- 14Employed by Adelphi when the study was conducted
- Corresponding author: Florian S. Gutzwiller (florian.gutzwiller{at}novartis.com)
Abstract
Introduction This patient preference study (PPS) sought to quantify the preferences of people living with chronic obstructive pulmonary disease (COPD) regarding symptom improvement in the United Kingdom, United States, France, Australia, and Japan.
Methods Inclusion criteria: People living with COPD aged 40 years or older who experienced ≥1 exacerbations in the previous year with daily symptoms of cough and excess mucus production. Study design: (I). development of an attributes and levels (A&L) grid through qualitative patient interviews; (II). implementation of the main online quantitative survey which included a discrete choice experiment (DCE) to allow assessment of attributes and levels using hypothetical health state profiles. Preference weights (utilities) were derived from the DCE using Hierarchical Bayesian analysis. A preference simulator was developed which enabled different health state scenarios to be evaluated based on the predicted patient preferences.
Results 1050 people living with moderate-to-severe COPD completed the survey. All attributes were considered important when patients determined their preferences in the DCE. In a health-state preference simulation, two hypothetical health states (comprising of attribute levels) with qualitatively equivalent improvements in A) cough and mucus and B) shortness of breath (SOB) resulted in a clear preference for cough and mucus-improved profile. When comparing two profiles with C) daily symptoms improved and D) exacerbations improved, there was a clear preference for the daily symptoms improved profile.
Conclusions People living with moderate-to-severe COPD prefer to reduce cough and mucus production together over improvement of SOB and would prefer to reduce combined daily symptoms over an improvement in exacerbations.
Footnotes
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Conflict of interest: Nigel S. Cook, Beyza Klein, Byron Jones and Florian S. Gutzwiller are Novartis employees and hold shares in Novartis. Katie Mycock, Phil Mellor, Pam Hallworth, Kate Sully and Sophi Tatlock are Adelphi employees; Tom Gardner was employee of Adelphi when the study was conducted and Adelphi received payment for conducting the study. Pierre-Régis Burgel has received a consultancy fee from Novartis for his support throughout this COPD patient preferences project. He received personal fees (advisory boards, lecturing) from Astra-Zeneca, Chiesi, GSK, Insmed, Novartis, Pfizer, Teva, Vertex and Zambon and research grants from GSK and Vertex. Gerard J. Criner received a consultancy fee from Novartis for his support throughout this COPD patient preferences project. He received personal fees (advisory boards, lecturing) from Glaxo Smith Kline, Astra Zeneca, Chiesi, Sanofi, Olympus, Broncus, Pulmonx, Aerwave, EOLO, Boehringer Ingerlheim. Olivier Le Rouzic received personal fees (advisory boards, lecturing) from AstraZeneca, Boehringer Ingelheim, Chiesi, GSK, Novartis. All five patient groups from five countries (British Lung Foundation, UK; COPD Foundation, US; La Fondation du Soufflé, France; Lung Foundation Australia, and J-Breath, Japan) each received a consultancy fee at fair market value as compensation for their services throughout this project.
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- Received December 24, 2021.
- Accepted April 1, 2022.
- Copyright ©The authors 2022
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