Treatment Mode Preferences in Psoriatic Arthritis: A Qualitative Multi-Country Study
Received 17 December 2019
Accepted for publication 7 May 2020
Published 8 June 2020 Volume 2020:14 Pages 949—961
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Johnny Chen
Daniel Aletaha,1 M Elaine Husni,2 Joseph F Merola,3 Roberto Ranza,4 Heidi Bertheussen,5 Ralph Lippe,6 Pamela M Young,7 Joseph C Cappelleri,8 T Michelle Brown,9 Claire Ervin,9 Ming-Ann Hsu,10 Lara Fallon11
1Division of Rheumatology, Department of Internal Medicine 3, Medical University of Vienna, Vienna, Austria; 2Cleveland Clinic, Department of Rheumatic and Immunologic Diseases, Cleveland, OH, USA; 3Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA; 4Serviço de Reumatología, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brazil; 5Patient Representative, Oslo, Norway; 6Inflammation & Immunology, Pfizer Pharma GmbH, Berlin, Germany; 7Inflammation & Immunology, Pfizer Inc, Collegeville, PA, USA; 8Statistics, Pfizer Inc, Groton, CT, USA; 9RTI Health Solutions, Research Triangle Park, NC, USA; 10Health Economics & Outcomes Research, Pfizer Inc, Groton, CT, USA; 11Medical Affairs, Pfizer Inc, Montreal, QC, Canada
Correspondence: Daniel Aletaha
Division of Rheumatology, Department of Internal Medicine 3, Medical University of Vienna, Währinger Gürtel 18– 20, Vienna 1090, Austria
Objective: Qualitative research exploring patient preferences regarding the mode of treatment administration for psoriatic arthritis (PsA) is limited. We report patient preferences and their reasons across PsA treatment modes.
Methods: In this global, cross-sectional, qualitative study, interviews were conducted with adult patients with PsA in Brazil, France, Germany, Italy, Spain, the UK, and the US. Patients were currently taking a disease-modifying antirheumatic drug (DMARD). Patients indicated the order and strength of preference (0– 100; 100 = strongest) across four modes of treatment administration: oral (once daily), self-injection (weekly), clinic injection (weekly), and infusion (monthly); reasons for preferences were qualitatively assessed. Descriptive statistics were reported. Fisher’s exact tests and t-tests were conducted for treatment mode outcomes.
Results: Overall, 85 patients were interviewed (female, 60.0%; mean age, 49.8 years). First-choice ranking (%) and mean [standard deviation] preference points were: oral (49.4%; 43.9 [31.9]); self-injection (34.1%; 32.4 [24.8]); infusion (15.3%; 14.5 [20.0]); clinic injection (1.2%; 9.2 [10.0]). Of 48 (56.5%) patients with a strong first-choice preference (ie point allocation ≥ 60), 66.7% chose oral administration. Self-injection was most often selected as second choice (51.8%), clinic injection as third (49.4%), and infusion as fourth (47.1%). Oral administration was the first-choice preference in the US (88.0% vs 38.0% in Europe). The most commonly reported reason for oral administration as the first choice was speed and ease of administration (76.2%); for self-injection, this was convenience (75.9%). The most commonly reported reason for avoiding oral administration was concern about possible drug interactions (63.6%); for self-injection, this was a dislike of needles or the injection process (66.7%).
Conclusion: Patients with PsA preferred oral treatment administration, followed by self-injection; convenience factors were common reasons for these preferences. Overall, 43.5% of patients did not feel strongly about their first-choice preference and may benefit from discussions with healthcare professionals about PsA treatment administration options.
Keywords: psoriatic arthritis, patient preference, qualitative research, treatment administration
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