The importance of potency and durability in HIV patient antiretroviral therapy preferences: a telephone survey

Abstract

Patients who were receiving or had received antiretroviral therapy (ART) participated in 45-minute telephone interviews to evaluate the importance of major treatment attributes. A Likert scale was used to quantify and rate the importance of 9 ART attributes. Trade-off exercises allowed participants to select a preferred hypothetical ART regimen from two options based on daily dosing and varied efficacy. Participants were asked to assume that all else about the medications was the same. A total of 387 patients were surveyed (72% male; 44% African American, 41% Hispanic; 28% with no high school diploma, 29% high school graduate, 25% college with no degree; 46% infected through men who have sex with men [MSM], 19% infected through injection drug use [IDU]). Efficacy attributes (lowering viral load, raising CD4, durability) were rated as "most important" or "very important" by significantly more patients than other attributes (resistance profile, appearance side effects, gastrointestinal side effects, dosing frequency, pill burden, cholesterol side effects). Similar results were seen for subgroups analyzed by gender, ethnicity, age, line of therapy, region, and route of infection. In the second set of questions, 92% of patients preferred more effective twice-daily regimens over less effective once-daily regimens, and 89% preferred more durable twice-daily regimens over less durable once-daily regimens. Results suggest that potency, immune improvement, and durability of ART regimens are more important to HIV patients than other attributes such as side effects, dosing frequency, or pill burden. These results, in conjunction with other studies, suggest that patients prioritize viral suppression, immune improvement, and regimen durability more highly than regimen convenience.