BACKGROUND: Current treatment options for migraine prevention differ in their attributes, including mode of administration, efficacy, and dosing frequency; preferences for such attributes can vary among patients. With the advent of new therapies, evidence demonstrating patient preferences for injected or infused preventive migraine treatments is necessary.
METHODS: Canadian adults self-reporting a diagnosis of migraine completed a cross-sectional, internet-based survey that included a discrete choice experiment. Participants were presented with attributes of preventive migraine treatments, including speed of onset, durability of efficacy, mode of administration, administration setting, and dosing frequency. Latent class analysis (LCA) was used to identify subgroups of patients who differed in their treatment preferences.
RESULTS: In total, 200 participants completed the survey. Participants\' treatment preferences were most sensitive to improvements in the durability of effectiveness from \"wears off 2 weeks before next dose\" to \"does not wear off before the next dose\" (absolute difference in weights = |-0.95 to 1.07| = 2.02) and improvements from \"cranial injections\" to \"intravenous infusions\" (|-1.04 to 0.58| = 1.62); participants equally preferred self-injection and intravenous infusion from a health-care provider (mean weight = 0.58 and 0.47, respectively) as a route of administration over cranial injections (mean weight = -1.04). Three subgroups were identified with LCA: group one (n = 103) prioritized fast-acting and durable therapies, group two (n = 54) expressed aversion to cranial injections, and group three (n = 43) favored treatments administered in a health-care provider setting.
CONCLUSIONS: In this sample of Canadian adults with migraine, we showed that durability of effectiveness and mode of administration are key attributes influencing patient preferences for preventive migraine treatments; however, certain groups of patients may differ in their treatment priorities. Our results highlight the need for patient-provider discussions regarding treatment attributes and consideration of patients\' preferences when selecting a preventive migraine treatment.
背景:目前预防偏头痛的治疗方案在属性上有所不同,包括管理模式,功效,和给药频率;患者对这些属性的偏好可能有所不同。随着新疗法的出现,需要有证据证明患者倾向于注射或输注预防性偏头痛治疗.
方法:加拿大成年人自我报告偏头痛的诊断完成了横断面,基于互联网的调查,包括一个离散的选择实验。向参与者展示了预防性偏头痛治疗的属性,包括发作速度,功效的耐久性,管理模式,管理设置,和给药频率。潜在类别分析(LCA)用于识别治疗偏好不同的患者亚组。
结果:总计,200名参与者完成了调查。参与者的治疗偏好对有效性持久性的改善最敏感,从“下一次给药前2周消失”到“下一次给药前不消失”(重量的绝对差异=|-0.95到1.07|=2.02),以及从“颅骨注射”到“静脉输液”(|-1.04到0.58|=1.62)的改善;参与者的平均体重分别为0.58和静脉输液(平均体重=1.62)。用LCA确定了三个亚组:第一组(n=103)优先考虑快速和持久的治疗,第二组(n=54)对颅脑注射表示厌恶,第三组(n=43)更喜欢在医疗保健提供者环境中进行的治疗。
结论:在这个加拿大成年人偏头痛的样本中,我们发现,有效性的持久性和给药方式是影响患者对预防性偏头痛治疗的偏好的关键属性;然而,某些患者组的治疗优先级可能有所不同.我们的研究结果突出表明,在选择预防性偏头痛治疗时,需要患者与提供者就治疗属性和考虑患者偏好进行讨论。