P1083 Patient preferences for Inflammatory Bowel Disease treatments: an international survey using a discrete choice experiment in partnership with EFCCA
Authors: Schoefs E , Janssens R , Gutiérrez-Vargas Á A , Ferrante M , Sabino J , Verstockt B , Avedano L , De Rocchis M S , Sajak-Szczerba M , Saldaña R , Straetemans N , Vandebroek M , Vermeire S , Huys I 
Published: January 2024

Background

As the therapeutic landscape for inflammatory bowel disease (IBD) continues to expand, this international patient preference study aimed to quantify IBD patients preferences for treatment and disease-related attributes.

Methods

A survey incorporating a discrete choice experiment (DCE) comprising 14 attributes with a partial profile design was disseminated globally among IBD patients. The survey design was informed by a prior literature review, qualitative research, and expert discussions. Multinomial logit models were used to estimate DCE attribute weights and assess potential interactions.

Results

A total of 1272 IBD patients across 37 countries completed the survey (Table 1). All parameters had the expected negative signs, meaning that the side effects or negative disease related outcomes in the survey had a negative impact in the patients’ utility. Additionally, they were significant predictors (p&lt;0.05) of patient choices. Among the different attributes, the severity of abdominal pain and cramps (11.35%) was considered the most important attribute, followed by urgency and pain of having to go to the toilet (11.91%), and severity of fatigue (10.62%). The lowest importance was assigned to the treatment mode of administration (2.56%), onset of action (3.22%), and endoscopic disease activity (3.57%) (Figure 1). Differences in patient's attribute weights were found between patients with Crohn’s disease and ulcerative colitis, with the former attaching more value to frequency of having to go to the toilet (p&lt;0.01), urgency and pain of having to go to the toilet (p&lt;0.001), risk of surgery (p&lt;0.001), and physical changes (p&lt;0.01). Interactions with age in the model showed that older patients attached less importance to treatment and disease-related attributes. Furthermore, females attached more value to severe infections (p&lt;0.001), physical changes (p&lt;0.001), and skin problems (p&lt;0.01). Some differences in preferences of patients in Northern, Eastern, Southern, and Western Europe were identified, with for example patients in Western Europe attaching more value to fatigue (p&lt;0.001), psychological impact (p&lt;0.001), sleeping problems (p&lt;0.001), and skin problems (p&lt;0.001) compared to patients in Eastern Europe.

Conclusion

Gastrointestinal problems were considered very important to IBD patients next to other quality of life-related attributes affecting IBD patients' physical, mental, and psychological health. Noteworthy, characteristics that distinguish the different treatments from each other (such as mode of administration and onset of action) seem less important to patients. Observed differences in patients preferences as revealed in the DCE emphasize the imperative role of shared decision making in treatment selection.