Patient preferences for treatment in type 2 diabetes: the Italian discrete-choice experiment analysis

Giulio Marchesini, Patrizio Pasqualetti, Roberto Anichini, Salvatore Caputo, Giuseppe Memoli, Paola Ponzani, Veronica Resi, Manfredi Rizzo, Gaetano Serviddio, Giorgio Zanette

Research output: Contribution to journalArticle

Abstract

Aims: Several drug classes are now available to achieve a satisfactory metabolic control in patients with type 2 diabetes (T2DM), but patients’ preferences may differ. Methods: In a discrete-choice experiment, we tested T2DM patients’ preferences for recent antidiabetic drugs, in the event that their treatment might require intensification. The following attributes were considered: (a) route of administration; (b) type of delivery; (c) timing; (d) risk of adverse events; (e) effects on body weight. Twenty-two possible scenarios were built, transferred into 192 paired choices and proposed to 491 cases naïve to injectable treatments and 171 treated by GLP-1 receptor agonists (GLP-1RAs). Analyses were performed by descriptive statistics and random effects logit regression model. Results: Preferences according to dosing frequency, risk of nausea and urinary tract infections (UTls) were similar across groups, age, sex and BMI. Administration route and delivery type accounted for 1/3 of relative importance; the risk of UTIs, nausea and dosing frequency for ≈ 20% each, and weight loss for only 6%. Two significant interactions emerged (p < 0.01): type of delivery × group, and weight change × BMI class. Irrespective of previous treatment, the three preferred choices were injectable, coupled with weekly dosing and a ready-to-use device (first two choices). In a regression model, being naïve or non-naïve changed the ranking of preferences (p < 0.001), and the order was systematically shifted towards injectable medications in non-naïve subjects. Conclusion: Easy-to-deliver, injectable treatment is preferred in T2DM, independently of treatment history, and previous experience with GLP-1RAs strengthens patients’ willingness to accept injectable drugs.

Original languageEnglish
Pages (from-to)289-299
JournalActa Diabetologica
Volume56
Issue number3
DOIs
Publication statusPublished - 2019

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Patient Preference
Type 2 Diabetes Mellitus
Injections
Nausea
Therapeutics
Hypoglycemic Agents
Urinary Tract Infections
Pharmaceutical Preparations
Weight Loss
Age Groups
Logistic Models
History
Body Weight
Weights and Measures
Equipment and Supplies
Glucagon-Like Peptide-1 Receptor

Keywords

  • Adverse events
  • Dose frequency
  • Glucagon-like peptide-1 receptor agonists
  • Injectable drugs
  • Nausea
  • Oral treatment
  • Route of delivery
  • Sodium–glucose co-transporter 2 inhibitors
  • Urogenital-tract infections
  • Weight loss

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Marchesini, G., Pasqualetti, P., Anichini, R., Caputo, S., Memoli, G., Ponzani, P., ... Zanette, G. (2019). Patient preferences for treatment in type 2 diabetes: the Italian discrete-choice experiment analysis. Acta Diabetologica, 56(3), 289-299. https://doi.org/10.1007/s00592-018-1236-6

Patient preferences for treatment in type 2 diabetes : the Italian discrete-choice experiment analysis. / Marchesini, Giulio; Pasqualetti, Patrizio; Anichini, Roberto; Caputo, Salvatore; Memoli, Giuseppe; Ponzani, Paola; Resi, Veronica; Rizzo, Manfredi; Serviddio, Gaetano; Zanette, Giorgio.

In: Acta Diabetologica, Vol. 56, No. 3, 2019, p. 289-299.

Research output: Contribution to journalArticle

Marchesini, G, Pasqualetti, P, Anichini, R, Caputo, S, Memoli, G, Ponzani, P, Resi, V, Rizzo, M, Serviddio, G & Zanette, G 2019, 'Patient preferences for treatment in type 2 diabetes: the Italian discrete-choice experiment analysis', Acta Diabetologica, vol. 56, no. 3, pp. 289-299. https://doi.org/10.1007/s00592-018-1236-6
Marchesini, Giulio ; Pasqualetti, Patrizio ; Anichini, Roberto ; Caputo, Salvatore ; Memoli, Giuseppe ; Ponzani, Paola ; Resi, Veronica ; Rizzo, Manfredi ; Serviddio, Gaetano ; Zanette, Giorgio. / Patient preferences for treatment in type 2 diabetes : the Italian discrete-choice experiment analysis. In: Acta Diabetologica. 2019 ; Vol. 56, No. 3. pp. 289-299.
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abstract = "Aims: Several drug classes are now available to achieve a satisfactory metabolic control in patients with type 2 diabetes (T2DM), but patients’ preferences may differ. Methods: In a discrete-choice experiment, we tested T2DM patients’ preferences for recent antidiabetic drugs, in the event that their treatment might require intensification. The following attributes were considered: (a) route of administration; (b) type of delivery; (c) timing; (d) risk of adverse events; (e) effects on body weight. Twenty-two possible scenarios were built, transferred into 192 paired choices and proposed to 491 cases na{\"i}ve to injectable treatments and 171 treated by GLP-1 receptor agonists (GLP-1RAs). Analyses were performed by descriptive statistics and random effects logit regression model. Results: Preferences according to dosing frequency, risk of nausea and urinary tract infections (UTls) were similar across groups, age, sex and BMI. Administration route and delivery type accounted for 1/3 of relative importance; the risk of UTIs, nausea and dosing frequency for ≈ 20{\%} each, and weight loss for only 6{\%}. Two significant interactions emerged (p < 0.01): type of delivery × group, and weight change × BMI class. Irrespective of previous treatment, the three preferred choices were injectable, coupled with weekly dosing and a ready-to-use device (first two choices). In a regression model, being na{\"i}ve or non-na{\"i}ve changed the ranking of preferences (p < 0.001), and the order was systematically shifted towards injectable medications in non-na{\"i}ve subjects. Conclusion: Easy-to-deliver, injectable treatment is preferred in T2DM, independently of treatment history, and previous experience with GLP-1RAs strengthens patients’ willingness to accept injectable drugs.",
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AU - Ponzani, Paola

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