Advanced

Exacerbations of COPD: quantifying the patient's perspective using discrete choice modelling

Haughney, J; Partridge, M R; Vogelmeier, C; Larsson, T; Kessler, R; Stahl, E; Brice, R and Löfdahl, Claes-Göran LU (2005) In European Respiratory Journal 26(4). p.623-629
Abstract
Patient-centred care is the current vogue in chronic obstructive pulmonary disease (COPD), but it is only recently that robust techniques have become available to determine patients' values and preferences. In this international cross-sectional study, patients' concerns and expectations regarding COPD exacerbations were explored using discrete choice modelling. A fractional factorial design was used to develop scenarios comprising a combination of levels for nine different attributes. In face-to-face interviews, patients were presented with paired scenarios and asked to choose the least preferable. Multinomial logit (with hierarchical Bayes) methods were used to estimate utilities. A total of 125 patients (82 males; mean age 66 yrs; 4.6... (More)
Patient-centred care is the current vogue in chronic obstructive pulmonary disease (COPD), but it is only recently that robust techniques have become available to determine patients' values and preferences. In this international cross-sectional study, patients' concerns and expectations regarding COPD exacerbations were explored using discrete choice modelling. A fractional factorial design was used to develop scenarios comprising a combination of levels for nine different attributes. In face-to-face interviews, patients were presented with paired scenarios and asked to choose the least preferable. Multinomial logit (with hierarchical Bayes) methods were used to estimate utilities. A total of 125 patients (82 males; mean age 66 yrs; 4.6 mean exacerbations(.)yr(-1)) were recruited. The attributes of exacerbations considered most important were impact on everyday life (20%) need for medical care (16%), number of future attacks (12%) and breathlessness (11 %). The next most important attributes were speed of recovery, productive cough and social impact (all 9%), followed by sleep disturbance and impact on mood (both 7%). Importantly, analysis of utility shifts showed that patients most feared being hospitalised, housebound or bedridden. These issues were more important than symptom improvement. Strategies for the clinical management of chronic obstructive pulmonary disease should clearly address patients' concerns and focus on preventing and treating exacerbations to avoid these feared outcomes. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
chronic obstructive pulmonary disease, discrete choice modelling, exacerbations, patient perceptions
in
European Respiratory Journal
volume
26
issue
4
pages
623 - 629
publisher
Eur Respiratory Soc
external identifiers
  • pmid:16204592
  • wos:000232417000011
  • scopus:26844541649
ISSN
1399-3003
DOI
10.1183/09031936.05.00142704
language
English
LU publication?
yes
id
bc087e2f-fab3-4076-b75c-0f59784f35d3 (old id 220270)
date added to LUP
2007-08-10 12:30:56
date last changed
2017-11-05 03:29:39
@article{bc087e2f-fab3-4076-b75c-0f59784f35d3,
  abstract     = {Patient-centred care is the current vogue in chronic obstructive pulmonary disease (COPD), but it is only recently that robust techniques have become available to determine patients' values and preferences. In this international cross-sectional study, patients' concerns and expectations regarding COPD exacerbations were explored using discrete choice modelling. A fractional factorial design was used to develop scenarios comprising a combination of levels for nine different attributes. In face-to-face interviews, patients were presented with paired scenarios and asked to choose the least preferable. Multinomial logit (with hierarchical Bayes) methods were used to estimate utilities. A total of 125 patients (82 males; mean age 66 yrs; 4.6 mean exacerbations(.)yr(-1)) were recruited. The attributes of exacerbations considered most important were impact on everyday life (20%) need for medical care (16%), number of future attacks (12%) and breathlessness (11 %). The next most important attributes were speed of recovery, productive cough and social impact (all 9%), followed by sleep disturbance and impact on mood (both 7%). Importantly, analysis of utility shifts showed that patients most feared being hospitalised, housebound or bedridden. These issues were more important than symptom improvement. Strategies for the clinical management of chronic obstructive pulmonary disease should clearly address patients' concerns and focus on preventing and treating exacerbations to avoid these feared outcomes.},
  author       = {Haughney, J and Partridge, M R and Vogelmeier, C and Larsson, T and Kessler, R and Stahl, E and Brice, R and Löfdahl, Claes-Göran},
  issn         = {1399-3003},
  keyword      = {chronic obstructive pulmonary disease,discrete choice modelling,exacerbations,patient perceptions},
  language     = {eng},
  number       = {4},
  pages        = {623--629},
  publisher    = {Eur Respiratory Soc},
  series       = {European Respiratory Journal},
  title        = {Exacerbations of COPD: quantifying the patient's perspective using discrete choice modelling},
  url          = {http://dx.doi.org/10.1183/09031936.05.00142704},
  volume       = {26},
  year         = {2005},
}