ATS 2021 will feature presentations of original research from accepted abstracts. Mini Symposia and Thematic Poster Sessions are abstract based sessions.
Please use the form below to browse scientific abstracts and case reports accepted for ATS 2021. Abstracts presented at the ATS 2021 will be published in the Online Abstract Issue of the American Journal of Respiratory and Critical Care Medicine, Volume 203, May 3, 2021.
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Patients with COPD Prefer Improvement of Cough and Mucus over Shortness of Breath and Improvement of Combined Daily Symptoms Over the Reduction of Exacerbations: A Multi-Country Patient Preference Study
Session Title
TP40 - TP040 COPD CLINICAL TRIALS AND THERAPIES
Abstract
A2260 - Patients with COPD Prefer Improvement of Cough and Mucus over Shortness of Breath and Improvement of Combined Daily Symptoms Over the Reduction of Exacerbations: A Multi-Country Patient Preference Study
Author Block: F. Gutzwiller1, G. J. Criner2, P. Burgel3, K. Mycock4, P. Mellor5, B. Klein6, B. Jones7, I. Bottoli8, N. Cook9; 1Health Economics and Outcomes Research, Novartis Pharma AG, Basel, Switzerland, 2Pulm & Crit Care Med, Temple Univ Hosp, Philadelphia, PA, United States, 3Cochin Hospital, PARIS, France, 4Real world, Adelphi Real World, Nether Alderley England, United Kingdom, 5Adelphi Group, Stockport England, United Kingdom, 6Patient Advocacy and Communications, Novartis Pharma AG, Basel, Switzerland, 7Biometrical, Novartis Pharma AG, Basel, Switzerland, 8Respiratory, Novartis Pharma AG, Basel, Switzerland, 9Global Pricing and Market Access, Novartis Pharma AG, Basel, Switzerland.
Introduction: COPD patients experience disruption of daily activities as they suffer from excess mucus, cough, and shortness of breath (SOB). In addition, acute episodes of exacerbations are less frequent but more debilitating. Patient preference studies (PPS) are a way to assess which aspects of a disease matter most to patients. Previous projects (Social Media Listening and Online Bulletin Board) highlighted the importance COPD patients place on symptoms. This study sought to quantify the preferences of COPD patients regarding symptom improvement in the United Kingdom, United States, France, Australia and Japan.Methods: The PPS was designed to have three phases: I) testing/finalization of attribute and levels grid through qualitative patient interviews; II) implementation of the main online quantitative survey; III) data analysis. Findings from qualitative research with patients, scientific advice received from clinical experts, patient groups and the National Institute for Health and Care Excellence (NICE, UK) were used to inform the study design using a discrete choice experiment (DCE). Preference weights (utilities) were derived from the DCE using multinomial logit (MNL) and Hierarchical Bayesian (HB) analysis, from which a preference simulator was developed. A range of scenarios were tested to examine the effect of changes in health status on predicted patient preferences, relative to COPD patients’ average profile.Results: In total, 1050 COPD patients (mean age 61 years, equal gender split) from five countries completed the survey. This population self-reported a high proportion of comorbid asthma (>40%) and patients with ≥2 exacerbations in the past year (50%). Analysis of changes in preference weights (utilities) for equivalent improvements shows that those for cough and mucus combined are higher (more valued) than those for SOB alone. As a result, if these improvements are included in a health-state preference simulation [with two profiles: A) cough and mucus improved and B) SOB improved] there is a preference for the cough and mucus-improved profile compared to improvement in SOB alone (Figure 1a). Furthermore, when comparing two profiles with A) daily symptoms improved and B) exacerbations improved, there is a preference for the daily symptoms improved profile (Figure 1b).
Conclusions: From the burden of living with COPD, patients prefer to reduce daily burden from cough and mucus production over improvement of SOB and prefer to reduce combined daily symptoms over an improvement in exacerbations. In this study, we showed that there is clear value for symptom-focused therapies to deliver meaningful patient-recognized benefit.
Author Block: F. Gutzwiller1, G. J. Criner2, P. Burgel3, K. Mycock4, P. Mellor5, B. Klein6, B. Jones7, I. Bottoli8, N. Cook9; 1Health Economics and Outcomes Research, Novartis Pharma AG, Basel, Switzerland, 2Pulm & Crit Care Med, Temple Univ Hosp, Philadelphia, PA, United States, 3Cochin Hospital, PARIS, France, 4Real world, Adelphi Real World, Nether Alderley England, United Kingdom, 5Adelphi Group, Stockport England, United Kingdom, 6Patient Advocacy and Communications, Novartis Pharma AG, Basel, Switzerland, 7Biometrical, Novartis Pharma AG, Basel, Switzerland, 8Respiratory, Novartis Pharma AG, Basel, Switzerland, 9Global Pricing and Market Access, Novartis Pharma AG, Basel, Switzerland.
Introduction: COPD patients experience disruption of daily activities as they suffer from excess mucus, cough, and shortness of breath (SOB). In addition, acute episodes of exacerbations are less frequent but more debilitating. Patient preference studies (PPS) are a way to assess which aspects of a disease matter most to patients. Previous projects (Social Media Listening and Online Bulletin Board) highlighted the importance COPD patients place on symptoms. This study sought to quantify the preferences of COPD patients regarding symptom improvement in the United Kingdom, United States, France, Australia and Japan.Methods: The PPS was designed to have three phases: I) testing/finalization of attribute and levels grid through qualitative patient interviews; II) implementation of the main online quantitative survey; III) data analysis. Findings from qualitative research with patients, scientific advice received from clinical experts, patient groups and the National Institute for Health and Care Excellence (NICE, UK) were used to inform the study design using a discrete choice experiment (DCE). Preference weights (utilities) were derived from the DCE using multinomial logit (MNL) and Hierarchical Bayesian (HB) analysis, from which a preference simulator was developed. A range of scenarios were tested to examine the effect of changes in health status on predicted patient preferences, relative to COPD patients’ average profile.Results: In total, 1050 COPD patients (mean age 61 years, equal gender split) from five countries completed the survey. This population self-reported a high proportion of comorbid asthma (>40%) and patients with ≥2 exacerbations in the past year (50%). Analysis of changes in preference weights (utilities) for equivalent improvements shows that those for cough and mucus combined are higher (more valued) than those for SOB alone. As a result, if these improvements are included in a health-state preference simulation [with two profiles: A) cough and mucus improved and B) SOB improved] there is a preference for the cough and mucus-improved profile compared to improvement in SOB alone (Figure 1a). Furthermore, when comparing two profiles with A) daily symptoms improved and B) exacerbations improved, there is a preference for the daily symptoms improved profile (Figure 1b).
Conclusions: From the burden of living with COPD, patients prefer to reduce daily burden from cough and mucus production over improvement of SOB and prefer to reduce combined daily symptoms over an improvement in exacerbations. In this study, we showed that there is clear value for symptom-focused therapies to deliver meaningful patient-recognized benefit.
