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. 2021 Mar 29;7(1):00497-2020.
doi: 10.1183/23120541.00497-2020. eCollection 2021 Jan.

What matters to people with severe asthma? Exploring add-on asthma medication and outcomes of importance

Vanessa L Clark  1   2 , Peter G Gibson  1   3 , Vanessa M McDonald  1   2   3
Affiliations

What matters to people with severe asthma? Exploring add-on asthma medication and outcomes of importance

Vanessa L Clark et al. ERJ Open Res. .

Abstract

There is an increasing number of new therapies for severe asthma; however, what outcomes people with severe asthma would like improved and what aspects they prioritise in new medications remain unknown. This study aimed to understand what outcomes are important to patients when prescribed new treatments and to determine the characteristics of importance to patients in their choice of asthma treatments. Participants with severe asthma (n=50) completed a cross-sectional survey that ranked 17 potential hypothetical outcomes of treatment using a seven-point Likert scale, as well as selecting their top five overall outcomes. Participants also completed hypothetical scenarios trading off medication characteristics for four hypothetical add-on asthma treatments. Participants (58% male), had a mean±sd age of 62.2±13.5 years. Their top three prioritised outcomes were: to improve overall quality of life (selected by 83% of people), reduce number and severity of asthma attacks (72.3%), and being able to participate in physical activity (59.6%) When trading off medication characteristics, the majority of patients with severe asthma chose the hypothetical medication with the best treatment efficacy (68%). However, a subgroup of patients prioritised the medication's side-effect profile and mode of delivery to select their preferred medication. People with severe asthma value improved quality of life as an important outcome of treatment. Shared decision-making discussions between clinicians and patients that centre around medication efficacy and side-effect profile can incorporate patient preferences for add-on therapy in severe asthma.

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Conflict of interest statement

Conflict of interest: V.L. Clark reports grants from the National Health and Medical Research Council during the conduct of the study and personal fees from AstraZeneca outside the submitted work. Conflict of interest: P.G. Gibson reports personal fees from AstraZeneca, GlaxoSmithKline and Novartis, and grants from AstraZeneca and GlaxoSmithKline, outside the submitted work. Conflict of interest: V.M. McDonald reports grants from the National Health and Medical Research Council during the conduct of the study; grants from the Hunter Medical Research Institute, the National Health and Medical Research Council, and the John Hunter Hospital Charitable Trust Research, and grants and personal fees from GSK, Menarini and AstraZeneca, outside the submitted work.

Figures

FIGURE 1
FIGURE 1
Outcomes of importance for people with severe asthma. Ranking on a 0 (this is not important to me) to 6 (this is very important to me) point Likert scale. Data are presented as mean±sd.
FIGURE 2
FIGURE 2
Proportion of the preferences nominated by participants when asked to select their top five.
FIGURE 3
FIGURE 3
Self-reported factors used to decide when given a choice of medication.
FIGURE 4
FIGURE 4
a) Overview of the features of the hypothetical medications. Several of the side-effects were “not a known side-effect”. b) Proportion of preference for each medication based on the effect of the medication on asthma treatment efficacy “outcomes” (exacerbations, steroid reduction), the logistics of the medication (tablet, injection, frequency of dose), potential side-effects of the medication and all these factors overall.
See this image and copyright information in PMC

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