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Quantifying the treatment goals of people recently diagnosed with schizophrenia using best–worst scaling

Authors Bridges JFP, Beusterien K, Heres S, Such P, Sánchez-Covisa J, Nylander AG, Chan E, de Jong-Laird A

Received 29 September 2017

Accepted for publication 28 November 2017

Published 4 January 2018 Volume 2018:12 Pages 63—70


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

John FP Bridges,1 Kathleen Beusterien,2 Stephan Heres,3 Pedro Such,4 Joaquín Sánchez-Covisa,5 Anna-Greta Nylander,4 Elcie Chan,6 Anne de Jong-Laird5

1Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 2Outcomes Research Strategies in Health, Washington DC, USA; 3Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany; 4Global Medical Affairs, H. Lundbeck A/S, Valby, Denmark; 5Medical Department, Otsuka Pharmaceutical Europe Ltd., Wexham, UK; 6HEOR/Market Access, Otsuka Pharmaceutical Europe Ltd., Wexham, UK

Objective: This study seeks to quantify the treatment goals of people recently diagnosed with schizophrenia and explore their impact on treatment plan.
Methods: People aged 18–35 years with a confirmed diagnosis of schizophrenia within the past 5 years were surveyed in the UK, Germany, and Italy. Treatment goals were assessed via a validated best–worst scaling instrument, where participants evaluated subsets of 13 possible treatment goals identified using a balanced incomplete block design. Participants identified the most and least important goals within each task. Data were also collected on current treatment and preference for daily oral versus long-acting injectable (LAI) treatment. Hierarchical Bayes was used to identify preference weights for the goals, and latent class analysis was used to identify segments of people with similar goals. The segments were compared with the current treatment and preference for oral versus LAI treatment.
Results: Across 100 participants, the average age was 26 years, 75% were male and 50% were diagnosed within 2 years ago. Overall, preferences were most favorable for reduced disease symptoms, think clearly, reduced hospitalizations, reduced anxiety, and take care of self. A total of 61% preferred oral medication and 39% LAI. Two groups were identified with different treatment goals; 50% of participants emphasized clinical goals, including reduced disease symptoms (preference weight =19.7%), reduced hospitalizations (15.5%), and reduced anxiety (10.5%). The other 50% emphasized functional goals, including improved relationships with family/friends (11.4%), increased interest in work (10.6%), experiencing a fuller range of emotions (8.4%), and ability to socialize (7.5%). Those emphasizing functional goals were more likely to be on LAI (44% versus 26%; p=0.059) and preferred LAI (46% versus 32%; p=0.151).
Conclusions: People with recent-onset schizophrenia may focus more on clinical goals or functional goals, a discussion of which may help facilitate patient engagement.

Keywords: recent-onset schizophrenia, preferences, treatment goals

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