Abstract
Summary
We studied the ranking of osteoporosis (OP) medication attributes in a convenience sample of four different racial/ethnic groups in the United States. Our study showed that postmenopausal women differ in the ranking of OP medication attributes based on age, educational level, income, and prior fracture history.
Introduction
Decision making about OP medication-related behavior relies heavily on patient preferences about specific medication attributes. Patients may decide to initiate, change, or stop therapies based on ranking of perceived attributes of the therapy and their personal attitudes toward those attributes. We used MaxDiff, a form of conjoint analysis (Ryan and Farrar 2000), to explore patient weighting of attributes across four racial/ethnic groups at two sites in the United States and defined four critical attributes that influence such decisions (safety, efficacy, cost, and convenience) from qualitative interviews.
Methods
We recruited a sample of 367 Postmenopausal (PM) women at risk of OP fractures from four racial/ethnic groups: Caucasian (n = 100), African American (n = 100), Asian American (n = 82), and Hispanic American (n = 85). Respondents completed a laptop-based questionnaire that included demographic items, several short scales on medical care preference and OP patient perceptions, and a MaxDiff procedure that determines comparative ranking of attributes either as least important or most important to their decisions.
Results
MaxDiff analyses were done to evaluate the relative weight of specific statements for each participant and to determine whether racial/ethnic groups differed across dimensions. Overall, participants in all four groups rated efficacy > safety > cost > convenience.
Conclusions
Although there were no significant differences among the racial/ethnic groups on overall ranking of attributes, subgroup analyses revealed significant impact of age, education, income, and prior fracture on these decisions. The findings from this study suggest that postmenopausal women differ in their ranking of OP medication attributes, and healthcare providers must account for personal preferences in their communication about and selection of OP medications.
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Acknowledgments
These data were presented at the 2011 Annual Scientific Meeting of the American Society for Bone and Mineral Research (abstract submitted: 4/11/2011; abstract accepted: 6/10/2011; presented on 9/17/2011). Support for this study was provided by Novartis Pharmaceuticals, Hanover, NJ, USA. We acknowledge the following individuals for their valuable roles in the conduct of this study: Joe Curry and Tai Nguyen for their formulation of the MaxDiff and its statistical analyses (Sawtooth, Inc.), Jim Mirocha for statistical analysis, and Amy Mofield (Duke) and Michael Silver (OMC) who participated in data collection.
Conflicts of interest
Stuart L. Silverman is a member of the advisory board of Lilly, Amgen and a consultant of Pfizer, Lilly, Amgen, and Roche. Silverman has also received research grants from Lilly, Amgen, Medtronics, Novartis, Pfizer, and Alliance for Better Bone Health. Deborah T. Gold is a member of the advisory board and a consultant of Lilly, Amgen. Gold has also received research grants from Novartis. Andrew Calderon, Kristina Kaw, Trenita Childers, Bethany Stafford, Wendy Brynildsen, Augusto Focil, and Michael Koenig have no conflicts of interest to report.
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Silverman, S., Calderon, A., Kaw, K. et al. Patient weighting of osteoporosis medication attributes across racial and ethnic groups: a study of osteoporosis medication preferences using conjoint analysis. Osteoporos Int 24, 2067–2077 (2013). https://doi.org/10.1007/s00198-012-2241-1
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DOI: https://doi.org/10.1007/s00198-012-2241-1