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Patient preferences for the treatment of type 2 diabetes in Australia: a discrete choice experiment

Abstract

Background

Australia has a high proportion of migrants, with an increasing migration rate from India. Type 2 diabetes is a chronic condition common amongst the Indian population. The decision to initiate and continue medication therapy (conventional or ayurvedic medicine) is complex and is influenced by a wide range of factors.

Objective

To determine preferences for conventional vs. ayurvedic medicines in Indian migrants with diabetes, and to identify the factors that may influence their preferences.

Methods

A discrete choice experiment was conducted with participants in Australia who were migrants from India with type 2 diabetes (n=141). Each respondent evaluated eight choice tasks consisting of eight attributes describing medicines and outcomes of medication taking; and were asked to choose ‘conventional’, or ‘ayurvedic’ medicine. A mixed multinomial logit model was used to estimate preferences.

Results

Overall, respondents’ preference to initiate a medicine was negative for both conventional (β=−2.33164, p<0.001) and ayurvedic medicines (β=−3.12181, p<0.001); however, significant heterogenicity was noted in participants’ preferences (SD: 2.33122, p<0.001). Six significant attributes were identified to influence preferences. In decreasing rank order: occurrence of hypoglycaemic events (relative importance, RI=24.33%), weight change (RI=20.00%), effectiveness of medicine (RI=17.91%), instructions to take with food (RI=17.05%), side effects (RI=13.20%) and formulation (RI=7.49%). Respondents preferred to initiate a medicine despite potential side effects.

Conclusions

There was a greater preference for conventional medicine, though neither were preferred. Medicine attributes and medication-taking outcomes influenced people’s preferences for an antidiabetic medicine. It is important to identify individual preferences during healthcare consultations to ensure optimal medication-taking.

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Acknowledgements

Sincere gratitude to all participants and Indian associations/organizations/new papers for their assistance in data collection throughout this project.

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Authors and Affiliations

Authors

Contributions

AA and PA designed the research study. AA analysed all the data and wrote the first draft of the manuscript. MUK and PA contributed significantly to all drafts of the manuscript and its final version. All authors have read and agreed with the final manuscript.

Corresponding author

Correspondence to Akram Ahmad.

Ethics declarations

Ethical approval

Ethical approval to conduct the research project was received from the Human Research Ethics Committee of university on 8 July 2020 (Project No.:2020/321). The survey was performed in compliance with the approved research protocol. Participation in the study was completely voluntary. As an online questionnaire was used, the respondents were in control of completing and submitting the questionnaire. The completion of the online survey was taken as evidence of consent to participate in the study.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Ahmad, A., Khan, M.U. & Aslani, P. Patient preferences for the treatment of type 2 diabetes in Australia: a discrete choice experiment. J Diabetes Metab Disord 21, 229–240 (2022). https://doi.org/10.1007/s40200-021-00962-5

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Keywords

  • Medicine
  • Ayurvedic
  • Diabetes Mellitus
  • Type 2
  • AYUSH
  • Complementary and alternative medicine
  • Conventional medicine
  • Discrete choice experiment
  • Factors
  • Indian migrants and patient preference