Patient and Healthcare Professional Preferences for Prescription Weight Loss Medications in Australia: Two Discrete Choice Experiments

Overview

Journal Patient Prefer Adherence

Date 2024 Feb 26

PMID 38406377

Authors

Simon Fifer

Brittany Keen

Anna Porter

Affiliations

Soon will be listed here.

Abstract

Purpose: Overweight and obesity are common in Australia and among the leading risk factors for ill health. Maintained weight loss of >5-10% can prevent and reduce the risk of obesity-related comorbidities. Prescription weight loss medications plus lifestyle interventions can result in additional weight loss compared with lifestyle interventions alone, but these medications are under-prescribed in Australia. Our aim was to develop a greater understanding of the treatment preferences of people with overweight or obesity and the healthcare practitioners (HCPs) who treat them.

Participants And Methods: An online survey of Australian adults with overweight or obesity and treating HCPs was conducted in 2020. A discrete choice experiment (DCE) approach was used to determine what is most important to people when evaluating oral and injectable prescription weight loss medications. Participants were asked to choose between three hypothetical treatment alternatives: "Oral pill"; "Subcutaneous injection pen (replaceable needle)"; "Disposable subcutaneous injection pen (hidden needle)"; and an opt-out option ("None of these").

Results: The online survey and DCE were completed by 193 patients and 104 HCPs. For both patients and HCPs, all treatment alternatives (oral, replaceable injection and disposable injection) were preferred over the opt-out. Gastrointestinal side effects, followed by success rate, percentage body weight lost, and cost were the most important attributes to patients. For HCPs, percentage body weight loss was the most important treatment attribute, followed by success rate, gastrointestinal side effects and cost. While most patients reported relatively low needle fear, physicians reported relatively high perceived patient needle fear.

Conclusion: Clinician-patient discussions about treatments for weight loss should cover the option of prescription weight loss medications, including injectable medications, which patients may be less apprehensive about than physicians believe. Treatments with a high success rate and low or manageable risk of gastrointestinal side effects may be preferred over alternatives.

References

Breslin M, Mullan R, Montori V . The design of a decision aid about diabetes medications for use during the consultation with patients with type 2 diabetes. Patient Educ Couns. 2008; 73(3):465-72. DOI: 10.1016/j.pec.2008.07.024. View

Clark M, Determann D, Petrou S, Moro D, de Bekker-Grob E . Discrete choice experiments in health economics: a review of the literature. Pharmacoeconomics. 2014; 32(9):883-902. DOI: 10.1007/s40273-014-0170-x. View

Lee P, Dixon J . Pharmacotherapy for obesity. Aust Fam Physician. 2017; 46(7):472-477. View

Bridges J, Hauber A, Marshall D, Lloyd A, Prosser L, Regier D . Conjoint analysis applications in health--a checklist: a report of the ISPOR Good Research Practices for Conjoint Analysis Task Force. Value Health. 2011; 14(4):403-13. DOI: 10.1016/j.jval.2010.11.013. View

Gonzalez J . A Guide to Measuring and Interpreting Attribute Importance. Patient. 2019; 12(3):287-295. DOI: 10.1007/s40271-019-00360-3. View

Guh D, Zhang W, Bansback N, Amarsi Z, Birmingham C, Anis A . The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009; 9:88. PMC: 2667420. DOI: 10.1186/1471-2458-9-88. View

LeBlanc E, Patnode C, Webber E, Redmond N, Rushkin M, OConnor E . Behavioral and Pharmacotherapy Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality in Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2018; 320(11):1172-1191. DOI: 10.1001/jama.2018.7777. View

Jensen M, Ryan D, Apovian C, Ard J, Comuzzie A, Donato K . 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2013; 129(25 Suppl 2):S102-38. PMC: 5819889. DOI: 10.1161/01.cir.0000437739.71477.ee. View

Fifer S, Puig A, Sequeira V, Acar M, Ng C, Blanchard M . Understanding Treatment Preferences of Australian Patients Living with Treatment-Resistant Depression. Patient Prefer Adherence. 2021; 15:1621-1637. PMC: 8309674. DOI: 10.2147/PPA.S311699. View

10.

Patterson L, Kee F, Hughes C, OReilly D . The relationship between BMI and the prescription of anti-obesity medication according to social factors: a population cross sectional study. BMC Public Health. 2014; 14:87. PMC: 3914727. DOI: 10.1186/1471-2458-14-87. View

11.

Gadde K, Atkins K . The limits and challenges of antiobesity pharmacotherapy. Expert Opin Pharmacother. 2020; 21(11):1319-1328. PMC: 7523877. DOI: 10.1080/14656566.2020.1748599. View

12.

Khera R, Murad M, Chandar A, Dulai P, Wang Z, Prokop L . Association of Pharmacological Treatments for Obesity With Weight Loss and Adverse Events: A Systematic Review and Meta-analysis. JAMA. 2016; 315(22):2424-34. PMC: 5617638. DOI: 10.1001/jama.2016.7602. View

13.

Fifer S, Galinsky J, Richard S . Myeloma Patient Value Mapping: A Discrete Choice Experiment on Myeloma Treatment Preferences in the UK. Patient Prefer Adherence. 2020; 14:1283-1293. PMC: 7395685. DOI: 10.2147/PPA.S259612. View

14.

Rigas G, Williams K, Sumithran P, Brown W, Swinbourne J, Purcell K . Delays in healthcare consultations about obesity - Barriers and implications. Obes Res Clin Pract. 2020; 14(5):487-490. DOI: 10.1016/j.orcp.2020.08.003. View

15.

Anderson B, Redondo M . What can we learn from patient-reported outcomes of insulin pen devices?. J Diabetes Sci Technol. 2012; 5(6):1563-71. PMC: 3262728. DOI: 10.1177/193229681100500633. View

16.

Merlo G, van Driel M, Hall L . Systematic review and validity assessment of methods used in discrete choice experiments of primary healthcare professionals. Health Econ Rev. 2020; 10(1):39. PMC: 7725112. DOI: 10.1186/s13561-020-00295-8. View

17.

Soekhai V, de Bekker-Grob E, Ellis A, Vass C . Discrete Choice Experiments in Health Economics: Past, Present and Future. Pharmacoeconomics. 2018; 37(2):201-226. PMC: 6386055. DOI: 10.1007/s40273-018-0734-2. View

18.

Fifer S, Rose J, Hamrosi K, Swain D . Valuing injection frequency and other attributes of type 2 diabetes treatments in Australia: a discrete choice experiment. BMC Health Serv Res. 2018; 18(1):675. PMC: 6117901. DOI: 10.1186/s12913-018-3484-0. View

19.

Mansfield C, Sikirica M, Pugh A, Poulos C, Unmuessig V, Morano R . Patient Preferences for Attributes of Type 2 Diabetes Mellitus Medications in Germany and Spain: An Online Discrete-Choice Experiment Survey. Diabetes Ther. 2017; 8(6):1365-1378. PMC: 5688991. DOI: 10.1007/s13300-017-0326-8. View

20.

Huq S, Todkar S, Lahiri S . PATIENT PERSPECTIVES ON OBESITY MANAGEMENT: NEED FOR GREATER DISCUSSION OF BMI AND WEIGHT-LOSS OPTIONS BEYOND DIET AND EXERCISE, ESPECIALLY IN PATIENTS WITH DIABETES. Endocr Pract. 2020; 26(5):471-483. DOI: 10.4158/EP-2019-0452. View