Patient preferences among third agent HIV medications: a US and German perspective

Beusterien, Kathleen; Dziekan, Kristina; Schrader, Shannon; Flood, Emuella; Flood, Rachael; Shearer, Arran; Davis, Elizabeth B.

doi:10.1080/09540120701294278

Cited by 23 publications

(24 citation statements)

References 21 publications

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“…Moreover, our findings were consistent with the finding of no substantial differences observed in relative importance of eleven of 12 side effects between HIV treatment-experienced, who may have experienced treatment side effects, versus treatment-naïve patients. 18 The current study also found that a more convenient administration regimen was more important to patients than severe side effects when the respective risk was less than 13%. Similarly, improved convenience has been found to be influential in treatment choices in other studies.…”

Section: Discussionmentioning

confidence: 69%

“…16 Specifically, Sun et al 16 evaluated preferences for 27 different side effects among patients with ovarian cancer. They found that severe nausea and vomiting was the least preferred toxicity and that "numbness in hands/feet" was among the most 18 Figure 3 Percentages of patients preferring treatments with differences in survival advantage and differences in regimen convenience, holding all other attributes constant.…”

Section: Discussionmentioning

confidence: 99%

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Patient preferences for chemotherapies used in breast cancer.

Beusterien¹,

Grinspan²,

Tencer³

et al. 2011

JCO

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Background: Therapies for invasive breast cancer may be associated with an incremental survival advantage that should be weighed against the risk of toxicities when making treatment decisions. The objective of this study was to elicit patient preferences for a comprehensive profile of attributes associated with chemotherapies for breast cancer. Methods: This was a cross-sectional study of 121 patients with stage I-IV breast cancer who completed an internet-based conjoint survey that assessed the following attributes: ten grade III/IV toxicities, survival advantage, and administration regimen. Literature and expert input were used to identify descriptions for each attribute and respective levels (eg, different risks of toxicities). Subjects rated the attribute levels on a series of scales and indicated preferences in pair-wise comparisons of two hypothetical treatments differing in attribute levels. Ordinary leastsquares regression was used to calculate utilities (preference weights) for each attribute level. Results: Of the twelve attributes, survival was the most important; specifically, a survival advantage of 3 months versus no survival advantage was most influential in the perceived value of chemotherapy. Among toxicities, the differences in the risks of neutropenia with hospitalization, diarrhea, nausea, and fatigue had the most impact on preferences; the risk differences of myalgia, stomatitis, and hand-foot syndrome had the least. In general, a more convenient administration regimen was less important than a 13% chance or more of severe toxicities, but more important than a 10%-12% chance of severe toxicities. Conclusion: Breast cancer patients place high value on small incremental survival advantages associated with treatment despite the risk of serious toxicities.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Patient preferences for chemotherapies used in breast cancer.

Beusterien¹,

Grinspan²,

Tencer³

et al. 2011

JCO

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“…The technique is widely used in marketing and several fields of economics including health [19,[35][36][37]. Patient preferences for HIV testing [31], HIV vaccines [29] and ART regimens [1] have been reported and although most CA studies are from highincome countries, at least one health CA has been reported from a low-income context [8].…”

Section: Introductionmentioning

confidence: 99%

Preferences for Characteristics of Antiretroviral Therapy Provision in Johannesburg, South Africa: Results of a Conjoint Analysis

et al. 2009

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A survey was administered to HIV-infected patients and a sample in Soweto and the Johannesburg inner city to measure preferences for antiretroviral therapy (ART) provision. The 25 to 49-year-old male and female respondents viewed 20 sets of three hypothetical ART clinic choices after reading information on ART. Each set had a permutation of four levels of: monthly ART price, clinic waiting times, HIV clinic branding and clinic staff attitudes. For each set, respondents selected the preferred mix of characteristics and indicated if they would pay for it. For every ZAR 100 (USD PPP 25) increase in price, the average probability of selecting a clinic decreased by 2.8 and 3.0% in the HIV patient and household samples, respectively. Cost as well as staff attitude, wait time, and clinic branding may constitute important barriers to ART uptake and adherence in resource-poor settings.

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“…Reasons for adherence levels below this threshold are complex. Several causal relationships have been suggested for suboptimal HIV treatment adherence, including complicated treatment regimens, patient-specific factors and treatment-related adverse events (AEs) [2][3][4][5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Neurological and psychiatric tolerability of rilpivirine (TMC278) vs. efavirenz in treatment‐naïve, HIV‐1‐infected patients at 48 weeks

Mills¹,

Antinori

Clotet

et al. 2013

HIV Medicine

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ObjectivesThe aim of the study was to compare the neuropsychiatric safety and tolerability of rilpivirine (TMC278) vs. efavirenz in a preplanned pooled analysis of data from the ECHO and THRIVE studies which compared the safety and efficacy of the two drugs in HIV-1 infected treatment naïve adults. MethodsECHO and THRIVE were randomized, double-blind, double-dummy, 96-week, international, phase 3 trials comparing the efficacy, safety and tolerability of rilpivirine 25 mg vs. efavirenz 600 mg once daily in combination with two background nucleoside/tide reverse transcriptase inhibitors. Safety and tolerability analyses were conducted when all patients had received at least 48 weeks of treatment or discontinued earlier. Differences between treatments in the incidence of neurological and psychiatric adverse events (AEs) of interest were assessed in preplanned statistical analyses using Fisher's exact test. ResultsAt the time of the week 48 analysis, the cumulative incidences in the rilpivirine vs. efavirenz groups of any grade 2-4 treatment-related AEs and of discontinuation because of AEs were 16% vs. 31% (P < 0.0001) and 3% vs. 8% (P = 0.0005), respectively. The incidence of treatmentrelated neuropsychiatric AEs was 27% vs. 48%, respectively (P < 0.0001). The incidence of treatment-related neurological AEs of interest was 17% vs. 38% (P < 0.0001), and that of treatment-related psychiatric AEs of interest was 15% vs. 23% (P = 0.0002). Dizziness and abnormal dreams/nightmares occurred significantly less frequently with rilpivirine vs. efavirenz (P < 0.01). In both groups, patients with prior neuropsychiatric history tended to report more neuropsychiatric AEs but rates remained lower for rilpivirine than for efavirenz. ConclusionsRilpivirine was associated with fewer neurological and psychiatric AEs of interest than efavirenz over 48 weeks in treatment-naïve, HIV-1-infected adults. Under current guidelines, the nonnucleoside reverse transcriptase inhibitor (NNRTI) efavirenz (EFV) is recommended as a preferred component of ARV regimens for treatment-naïve patients [11]. EFV has good overall tolerability but has been associated with some AE-related concerns, particularly neuropsychiatric symptoms that typically begin shortly after therapy initiation [12][13][14]. An analysis of four phase 2/3 controlled clinical trials has shown that 53% of EFV vs. 25% of control recipients reported central nervous system AEs (all grades) [1,3]. While EFV-associated neuropsychiatric AEs are often transient, symptoms such as abnormal dreams, dizziness, somatization, irritability and stress can persist in some instances for several months to years [15][16][17][18][19][20], and patients may experience symptoms of depression at any time during treatment [12,13].Several studies have compared the incidences of neuropsychiatric AEs with EFV-based vs. non-EFV-based ARV regimens [21][22][23][24]. Maintenance of virological control and significant improvement in neuropsychiatric AEs were demonstrated by switching from an EFV-to a nevirapinebase...

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Patient preferences among third agent HIV medications: a US and German perspective

Cited by 23 publications

References 21 publications

Patient preferences for chemotherapies used in breast cancer.

Patient preferences for chemotherapies used in breast cancer.

Preferences for Characteristics of Antiretroviral Therapy Provision in Johannesburg, South Africa: Results of a Conjoint Analysis

Neurological and psychiatric tolerability of rilpivirine (TMC278) vs. efavirenz in treatment‐naïve, HIV‐1‐infected patients at 48 weeks

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