@article {Cook00686-2021, author = {Nigel S. Cook and Gerard J. Criner and Pierre-R{\'e}gis Burgel and Katie Mycock and Tom Gardner and Phil Mellor and Pam Hallworth and Kate Sully and Sophi Tatlock and Beyza Klein and Byron Jones and Olivier Le Rouzic and Kip Adams and Kirsten Phillips and Mike McKevitt and Kazuko Toyama and Florian S. Gutzwiller}, title = {People living with Moderate-to-Severe COPD Prefer Improvement of Daily Symptoms Over the Improvement of Exacerbations: A Multi-Country Patient Preference Study}, elocation-id = {00686-2021}, year = {2022}, doi = {10.1183/23120541.00686-2021}, publisher = {European Respiratory Society}, 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.FootnotesThis 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: 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-R{\'e}gis 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 Souffl{\'e}, 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.}, URL = {https://openres.ersjournals.com/content/early/2022/04/07/23120541.00686-2021}, eprint = {https://openres.ersjournals.com/content/early/2022/04/07/23120541.00686-2021.full.pdf}, journal = {ERJ Open Research} }