Abstract:
Background and objective: Long-term adherence to inhaled corticosteroids is poor despite the
crucial role of preventer medications in achieving good asthma outcomes. This study was undertaken
to explore patient preferences in relation to their current inhaled corticosteroid medication, a
hypothetical preventer or no medication.
Methods: A discrete choice experiment was conducted in 57 adults with mild–moderate asthma
and airway hyper-responsiveness, who were using inhaled corticosteroid ≤500 μg/day (beclomethasone
equivalent). In the discrete choice experiment, subjects evaluated 16 hypothetical scenarios
made up of 10 attributes that described the process and outcomes of taking asthma medication, with
two to four levels for each attribute. For each scenario, subjects chose between the hypothetical
medication, the medication they were currently taking and no asthma medication. A random parameter
multinomial logit model was estimated to quantify subject preferences for the aspects of taking
asthma medication and the influence of attributes on medication decisions.
Results: Subjects consistently made choices in favour of being able to do strenuous and sporting
activities with or without reliever, experiencing no side-effects and never having to monitor their
peak flow. Frequency of collecting prescriptions, frequency of taking the medication, its route of
administration and the strength of the doctor recommendation about the medication were not
significant determinants of choice.
Conclusions: The results of this study suggest that patients prefer a preventer that confers capacity
to maximize physical activity, has no side-effects and does not require daily peak flow monitoring.
