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. 2018 Feb;41(2):179-189.
doi: 10.1007/s40264-017-0601-7.

Preferences of Patients and Pharmacists with Regard to the Management of Drug-Drug Interactions: A Choice-Based Conjoint Analysis

Mette Heringa  1   2   3 , Annemieke Floor-Schreudering  4   5 , Hans Wouters  6 , Peter A G M De Smet  7 , Marcel L Bouvy  4   5
Affiliations

Preferences of Patients and Pharmacists with Regard to the Management of Drug-Drug Interactions: A Choice-Based Conjoint Analysis

Mette Heringa et al. Drug Saf. 2018 Feb.

Abstract

Introduction: The management of drug-drug interactions (DDIs) is a complex process in which risk-benefit assessments should be combined with the patient's perspective.

Objective: The aim of this study was to determine patients' and pharmacists' preferences regarding DDI management.

Methods: We conducted a choice-based conjoint survey about a fictitious DDI concerning the combination of a cardiovascular drug and an antibiotic for pneumonia. Patients and pharmacists had to choose 12 times between two management options. The options were described by five attributes, including risk, benefit and practical consequences. Each attribute could have two different levels, which were varied over the choice tasks. Latent class analysis was used to identify potential classes of respondents with distinct patterns of similar preferences.

Results: In total, 298 patients and 178 pharmacists completed the questionnaire. The latent class model for both patients and pharmacists resulted in three classes. For patients, in one class the most importance was attached to avoiding switch of medication (class probability 20%), in a second class to fewer adverse events (41%), and in a third class to blood sampling (39%). For pharmacists, again one class attached the highest importance to avoiding switch of medication (31%). The other classes gave priority to curing pneumonia (31%) and avoiding blood sampling (38%).

Conclusion: The results showed diverging preferences regarding DDI management among both patients and pharmacists. Different groups attached different value to risk and benefit versus practical considerations. Awareness of existing variability in preferences among and between pharmacists and patients is a step towards shared decision making in DDI management.

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Conflict of interest statement

Funding

MH received an unconditional grant from Sawtooth Software for using Sawtooth Software Lighthouse Studio and Sawtooth Software Hosting. This research received no other specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Conflicts of interest

Mette Heringa, Annemieke Floor-Schreudering, Hans Wouters, Peter A.G.M. De Smet and Marcel L. Bouvy have no conflicts of interest that are directly relevant to the content of this study.

Human Subjects

The Institutional Review Board of the Division of Pharmacoepidemiology and Clinical Pharmacology of Utrecht University approved the investigation, and the work was conducted in compliance with its requirements. Only anonymous data were collected. Respondents did not sign informed consent, as an anonymous survey among volunteers did not fall within the scope of the Dutch Act on Medical Research Involving Human Subjects.

Figures

Fig. 1
Fig. 1
Annotated example of choice set for patients. Example of a choice set, starting with a short description of the case (wording for patients). The choice set shows two options; respondents have to choose either option A or option B. For the complete questionnaire, see Electronic Supplementary Material 1
Fig. 2
Fig. 2
Flowchart respondents
See this image and copyright information in PMC

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