People living with moderate-to-severe COPD prefer improvement of daily symptoms over the improvement of exacerbations: a multicountry patient preference study.

This patient preference study sought to quantify the preferences of people living with COPD regarding symptom improvement in the UK, USA, France, Australia and Japan. The inclusion criteria were people living with COPD aged 40 years or older who experienced ≥1 exacerbation in the previous year with daily symptoms of cough and excess mucus production. The study design included: 1) development of an attributes and levels grid through qualitative patient interviews; and 2) implementation of the main online quantitative survey, which included a discrete choice experiment (DCE) to allow assessment of attributes and levels using hypothetical health state profiles. Preference weights (utilities) were derived from the DCE using hierarchical Bayesian analysis. A preference simulator was developed that enabled different health state scenarios to be evaluated based on the predicted patient preferences. 1050 people living with moderate-to-severe COPD completed the survey. All attributes were considered important when patients determined their preferences in the DCE. In a health state preference simulation, two hypothetical health states (comprising attribute levels) with qualitatively equivalent improvements in A) cough and mucus and B) shortness of breath (SOB) resulted in a clear preference for cough and mucus improved profile. When comparing two profiles with C) daily symptoms improved and D) exacerbations improved, there was a clear preference for the daily symptoms improved profile. People living with moderate-to-severe COPD prefer to reduce cough and mucus production together over improvement of SOB and would prefer to reduce combined daily symptoms over an improvement in exacerbations.

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Déclaration de conflit d'intérêts

Conflict of interest: N.S. Cook, B. Klein, B. Jones and F.S. Gutzwiller are Novartis employees and hold shares in Novartis. K. Mycock, P. Mellor, P. Hallworth, K. Sully and S. Tatlock are Adelphi employees; T. Gardner was an employee of Adelphi when the study was conducted; and Adelphi received payment for conducting the study. P-R. Burgel has received a consultancy fee from Novartis for his support throughout this COPD patient preferences project. He received personal fees (advisory boards and lecturing) from AstraZeneca, Chiesi, GSK, Insmed, Novartis, Pfizer, Teva, Vertex and Zambon, and research grants from GSK and Vertex. G.J. Criner received a consultancy fee from Novartis for his support throughout this COPD patient preferences project. He received personal fees (advisory boards and lecturing) from GSK, Astra Zeneca, Chiesi, Sanofi, Olympus, Broncus, Pulmonx, Aerwave, EOLO and Boehringer Ingelheim. O. Le Rouzic received personal fees (advisory boards and lecturing) from AstraZeneca, Boehringer Ingelheim, Chiesi, GSK and Novartis. O. Le Rouzic, K. Adams, K. Phillips, M. McKevitt and K. Toyama declare that the five patient groups from five countries (British Lung Foundation, UK; COPD Foundation, USA; La Fondation du Soufflé, France; Lung Foundation Australia; and J-Breath, Japan) each received a consultancy fee at fair market value as compensation for their services throughout this project.