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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Effect of Socioeconomic, Demographic and Clinical Factors on Asthma Treatment Preferences: A Discrete Choice Experiment
Session Title
TP15 - TP015 UPDATES IN ADHERENCE AND TREATMENT OF LUNG DISEASE
Abstract
A1597 - Effect of Socioeconomic, Demographic and Clinical Factors on Asthma Treatment Preferences: A Discrete Choice Experiment
Author Block: M. George1, E. Israel2, N. Farooqui3, I. A. Gilbert4, H. Gandhi4, T. Tervonen5, Z. Balantac6, C. Thomas5, N. Krucien7, C. Gillette8; 1Columbia University School of Nursing, New York, NY, United States, 2Brigham and Womens Hospital, Boston, MA, United States, 3Allergy Partners, Fishers, IN, United States, 4AstraZeneca, Wilmington, DE, United States, 5Evidera, London, United Kingdom, 6Evidera, San Francisco, CA, United States, 7Evidera, Ivry-sur-Seine, France, 8Wake Forest School of Medicine, Winston-Salem, NC, United States.
Rationale: Understanding how patients with asthma value different aspects of their treatment can inform shared decision-making. We examined how patients’ preferences differ based on socioeconomic, demographic, and clinical factors. Methods: An online discrete choice experiment (DCE) was conducted in US adults with asthma. Treatment attributes were selected based on literature review and patient focus groups. The effects of socioeconomic factors (residential environment, health insurance), demographics (age, sex, race/ ethnicity), and clinical factors (asthma control, GINA step-level severity, healthcare provider) on asthma treatment preferences were examined using a multinomial logit model, where influential factors were identified by least absolute shrinkage and selection operator analysis (Figure). Results: The DCE was completed by 1,184 adults with asthma (60% female; mean age [SD], 49 [15] years; 37% well-controlled; 68% GINA step-therapy 1-2; 15% Black; 15% Hispanic). Men placed less value than women on reducing rescue medication use (odds ratio [OR]=0.88), reducing courses of oral corticosteroids (OR=0.83), reducing risk of oral thrush (OR=0.84), and reducing weight gain (OR=0.63). Black patients placed less value than non-Black patients on reducing oral corticosteroid courses (OR=0.78) and reducing weight gain (OR=0.84). Hispanic patients placed more value than non-Hispanic patients on decreasing the number of attacks requiring an urgent visit to a healthcare provider (HCP) or hospital (OR=1.29) and reducing risk of oral thrush (OR=1.20). Patients living in urban areas placed less value than patients in suburban areas on reducing oral corticosteroid courses (OR=0.80) and decreasing number of attacks requiring an urgent visit to a HCP or hospital (OR=0.75). Patients with well-controlled asthma placed more value than those with not well- or very poorly controlled asthma on reducing oral corticosteroid courses (OR=1.28), decreasing attacks requiring an urgent visit to a HCP or hospital (OR=1.27), and reducing weight gain (OR=1.35). Patients at a higher GINA step-level severity (3-5) placed more value than those at a lower GINA step-level severity (1-2) on reducing oral corticosteroid courses (OR=1.27) and reducing risk of oral thrush (OR=1.17). Patients whose asthma was managed only by primary care placed more value than those with specialist providers on reducing rescue medication use (OR=1.20), reducing weight gain (OR=1.17), and having 1 inhaler to use only as needed (OR=1.17). Conclusion: Sex, race, ethnicity, residential environment, level of asthma control, GINA severity, and healthcare provider type are key factors influencing treatment preferences of US adults with asthma. Provider awareness of these preferences can improve communication and outcomes. Funding: AstraZeneca
Author Block: M. George1, E. Israel2, N. Farooqui3, I. A. Gilbert4, H. Gandhi4, T. Tervonen5, Z. Balantac6, C. Thomas5, N. Krucien7, C. Gillette8; 1Columbia University School of Nursing, New York, NY, United States, 2Brigham and Womens Hospital, Boston, MA, United States, 3Allergy Partners, Fishers, IN, United States, 4AstraZeneca, Wilmington, DE, United States, 5Evidera, London, United Kingdom, 6Evidera, San Francisco, CA, United States, 7Evidera, Ivry-sur-Seine, France, 8Wake Forest School of Medicine, Winston-Salem, NC, United States.
Rationale: Understanding how patients with asthma value different aspects of their treatment can inform shared decision-making. We examined how patients’ preferences differ based on socioeconomic, demographic, and clinical factors. Methods: An online discrete choice experiment (DCE) was conducted in US adults with asthma. Treatment attributes were selected based on literature review and patient focus groups. The effects of socioeconomic factors (residential environment, health insurance), demographics (age, sex, race/ ethnicity), and clinical factors (asthma control, GINA step-level severity, healthcare provider) on asthma treatment preferences were examined using a multinomial logit model, where influential factors were identified by least absolute shrinkage and selection operator analysis (Figure). Results: The DCE was completed by 1,184 adults with asthma (60% female; mean age [SD], 49 [15] years; 37% well-controlled; 68% GINA step-therapy 1-2; 15% Black; 15% Hispanic). Men placed less value than women on reducing rescue medication use (odds ratio [OR]=0.88), reducing courses of oral corticosteroids (OR=0.83), reducing risk of oral thrush (OR=0.84), and reducing weight gain (OR=0.63). Black patients placed less value than non-Black patients on reducing oral corticosteroid courses (OR=0.78) and reducing weight gain (OR=0.84). Hispanic patients placed more value than non-Hispanic patients on decreasing the number of attacks requiring an urgent visit to a healthcare provider (HCP) or hospital (OR=1.29) and reducing risk of oral thrush (OR=1.20). Patients living in urban areas placed less value than patients in suburban areas on reducing oral corticosteroid courses (OR=0.80) and decreasing number of attacks requiring an urgent visit to a HCP or hospital (OR=0.75). Patients with well-controlled asthma placed more value than those with not well- or very poorly controlled asthma on reducing oral corticosteroid courses (OR=1.28), decreasing attacks requiring an urgent visit to a HCP or hospital (OR=1.27), and reducing weight gain (OR=1.35). Patients at a higher GINA step-level severity (3-5) placed more value than those at a lower GINA step-level severity (1-2) on reducing oral corticosteroid courses (OR=1.27) and reducing risk of oral thrush (OR=1.17). Patients whose asthma was managed only by primary care placed more value than those with specialist providers on reducing rescue medication use (OR=1.20), reducing weight gain (OR=1.17), and having 1 inhaler to use only as needed (OR=1.17). Conclusion: Sex, race, ethnicity, residential environment, level of asthma control, GINA severity, and healthcare provider type are key factors influencing treatment preferences of US adults with asthma. Provider awareness of these preferences can improve communication and outcomes. Funding: AstraZeneca
