TY  - JOUR
A1  - Rosenow, Felix
A1  - Winter, Yaroslav
A1  - Leunikava, Iryna
A1  - Brunnert, Marcus
A1  - Jöres, Lars
A1  - Sutphin, Jessie
A1  - Boeri, Marco
A1  - Smith, Jasmine
A1  - Villani, Flavio
A1  - Brandt, Christian
T1  - Relative importance of clinical outcomes and safety risks of antiseizure medication monotherapy for patients and physicians: Discrete choice experiment eliciting preferences in real-world study 'VOTE'
T2  - Epilepsia
N2  - Objective: This study was undertaken to elicit patients' preferences for attributes characterizing antiseizure medication (ASM) monotherapy options before treatment consultation, and to explore the trade-offs patients consider between treatment efficacy and risks of side effects. Further objectives were to explore how treatment consultation may affect patient preferences, to elicit physicians' preferences in selecting treatment, and to compare patient and physician preferences for treatment.
Methods: This prospective, observational study (EP0076; VOTE) included adults with focal seizures requiring a change in their ASM monotherapy. Patients completed a discrete choice experiment (DCE) survey before and after treatment consultation. Physicians completed a similar survey after the consultation. The DCE comprised 12 choices between two hypothetical treatments defined by seven attributes. The conditional relative importance of each attribute was calculated.
Results: Three hundred ten patients (mean [SD] age = 46.8 [18.3] years, 52.3% female) were enrolled from eight European countries, of whom 305 completed the survey before consultation and 273 completed the survey before and after consultation. Overall, this preference study in patients who intended to receive a new ASM monotherapy suggests that patient preferences were ordered as expected, with better outcomes being preferred to worse outcomes; patients preferred a higher chance of seizure freedom, lower risk of developing clinical depression, and fewer severe adverse events; avoiding moderate-to-severe “trouble thinking clearly” was more important than avoiding any other side effect. There were qualitative differences in what patients and physicians considered to be the most important aspects of treatment for patients; compared with patients, physicians had a qualitatively stronger preference for greater chance of seizure freedom and avoiding personality changes. Patients' preference weights were qualitatively similar before and after treatment consultation.
Significance: For patients, seizure freedom and avoiding trouble thinking clearly were the most important treatment attributes. Physicians and patients may differ in the emphasis they place on specific attributes.
KW  - antiepileptic drug
KW  - efficacy
KW  - patient preferences
KW  - shared decision-making
KW  - tolerability
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/75306
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-753066
SN  - 1528-1167
N1  - This study was funded by UCB Pharma.
VL  - 63
IS  - 2
SP  - 451
EP  - 462
PB  - Wiley-Blackwell
CY  - Oxford [u.a.]
ER  -