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. 2023 Oct 12:17:2545-2555.
doi: 10.2147/PPA.S419143. eCollection 2023.

Prioritizing Treatment Goals of People Diagnosed with Bipolar I Disorder in the US: Best-Worst Scaling Results

John F P Bridges #  1 , Joseph F Goldberg #  2 , Heather M Fitzgerald #  3 , Sanjeda R Chumki #  4 , Kathleen Beusterien #  5 , Oliver Will #  5 , Leslie Citrome #  6
Affiliations

Prioritizing Treatment Goals of People Diagnosed with Bipolar I Disorder in the US: Best-Worst Scaling Results

John F P Bridges et al. Patient Prefer Adherence. .

Abstract

Purpose: Bipolar I disorder (BP-I) is associated with significant disease burden, but evidence on treatment goals in people diagnosed with BP-I is scarce. This study sought to quantify treatment goals related to the pharmacological management of BP-I in adults in the US and to identify if subgroups of people with similar treatment goals exist.

Patients and methods: A best-worst scaling (BWS) of treatment goals was developed based on available literature and input from experts and patients and was distributed as part of a survey between August and September 2021. Survey participants were adults with a self-reported diagnosis of BP-I who were recruited via an online panel in the US. Participants were asked to prioritize the importance of 16 treatment goals using BWS. BWS scores were computed using multinomial logistic regression, with the scores across all goals summing to 100 for each participant. Subgroups of people with similar preferences were identified using latent class analysis.

Results: The most important treatment goals for people diagnosed with BP-I (N=255) were "being less impulsive, angry, or irritable" (score: 9.73), or being "able to feel pleasure or happiness" (score: 9.54). Goals related to reducing the incidence of various potential adverse events of medication (scores: ≤4.51) or "reducing dependence on others" (score: 3.04) were less important. Two subgroups were identified. One subgroup (n=111) prioritized symptom-focused goals, considering "reducing frequency of mania, depression, and mixed episodes" and "being less impulsive, angry or irritable" the most important (scores: 12.46 and 11.85, respectively). The other subgroup (n=144) placed significantly more importance on social functioning-focused goals, including beginning or maintaining a relationship with a partner/significant other, and with family and/or friends (scores: 8.45 and 7.70, respectively).

Conclusion: People diagnosed with BP-I prioritized emotional improvements. Subgroups of people with BP-I prioritized either symptom-focused or social functioning-focused treatment goals.

Keywords: healthcare questionnaire; patient preference; social functioning; treatment individualization.

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Conflict of interest statement

John F. P. Bridges has previously served as a consultant for Otsuka and Lundbeck. Joseph F. Goldberg has served as a consultant for BioXcel, Jazz Pharmaceuticals, Lundbeck, Neumora, Neurelis, Otsuka, Sage Pharmaceuticals, Sunovion, Supernus, and Takeda. He is on the Speakers’ bureau for AbbVie, Alkermes, Axsome, Intra-Cellular Therapies, and Sunovion. He has received royalties from American Psychiatric Publishing and Cambridge University Press. At the time of the survey, Heather M. Fitzgerald was a full-time employee of Lundbeck LLC, Deerfield, IL, USA. Sanjeda R. Chumki is a full-time employee of Otsuka Pharmaceutical Development & Commercialization Inc, Princeton, NJ, USA. Kathleen Beusterien and Oliver Will are employees of Cerner Enviza, which provides consulting services to Lundbeck and Otsuka. Leslie Citrome has served as consultant to AbbVie/Allergan, Acadia, Adamas, Alkermes, Angelini, Astellas, Avanir, Axsome, BioXcel, Boehringer Ingelheim, Cadent Therapeutics, Cerevel, Clinilabs, COMPASS, Eisai, Enteris BioPharma, HLS Therapeutics, Idorsia, Impel, INmune Bio, Intra-Cellular Therapies, Janssen, Karuna, Lundbeck, Lyndra, Marvin, Medavante-ProPhase, Merck, Mitsubishi-Tanabe Pharma, Neurelis, Neurocrine, Novartis, Noven, Otsuka, Ovid, Praxis, Recordati, Relmada, Reviva, Sage, Sunovion, Supernus, Teva, University of Arizona, Vanda, and one-off ad hoc consulting for individuals/entities conducting marketing, commercial, or scientific scoping research. He has served as speaker for AbbVie/Allergan, Acadia, Alkermes, Angelini, Axsome, BioXcel, Eisai, Idorsia, Intra-Cellular Therapies, Janssen, Lundbeck, Neurocrine, Noven, Otsuka, Recordati, Sage, Sunovion, Takeda, Teva, and CME activities organized by medical education companies such as Medscape, NACCME, NEI, Vindico, and universities and professional organizations/societies. He holds a small number of shares of common stock with Bristol-Myers Squibb, Eli Lilly, Johnson & Johnson, Merck, and Pfizer (purchased >10 years ago) and currently has options for acquiring stocks with Reviva. He has received royalties or income from publishing from Taylor & Francis (Current Medical Research and Opinion, 2022–date), Wiley (International Journal of Clinical Practice, through end 2019), UpToDate, Springer Healthcare, Elsevier (Psychiatry, Clinical Therapeutics). The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Latent class analysis of the importance of treatment goals for different subgroups of participants, listed from most important to least important according to the symptom-focused group. The 16 survey items had points allocated within a 100-point scale, with 6.25 being the null hypothesis on this scale, representing an item in the middle of a scale from most important to least important. All goals scoring above 6.25 (denoted by the dashed line) should be viewed as important. The higher the value, the more important the attribute relative to the other attributes included in the exercise. P-values were derived from an independent samples t-test.
Figure 2
Figure 2
Future plans made difficult by BP-I. P-values for the between-group difference were derived from independent sample tests of proportions.
See this image and copyright information in PMC

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