Patient preference for chronic obstructive pulmonary disease (COPD) treatment inhalers: a discrete choice experiment in France

Abstract

Objectives: Understanding inhaler preferences may contribute to improving adherence in COPD patients and improving long-term outcomes. This study aims to identify and quantify preferences for convenience-related inhaler attributes in French moderate-to-severe COPD patients, with discrete choice experiment (DCE) methodology.

Methods: Attributes were defined from a literature search, clinician and patient interviews: shape, dose insertion, dose preparation, dose release, dose confirmation, dose counter and reusability. An online DCE was conducted in respondents with self-reported COPD stage 2–4 recruited through a panel. The study questionnaire included twelve choice scenarios per respondent and questions on patient characteristics, treatment and disease severity. Statistical analyses used a mixed logit regression model with random effects. Utility scores were estimated for four types of inhalers: Inhaler A – soft mist inhaler; Inhaler B – reusable soft mist inhaler; Inhaler C – multi-dose dry powder inhaler; and Inhaler D – single dose dry powder inhaler.

Results: The study was completed by 153 patients (50 females); respondents were 50.4 years old on average; 13 different inhaler devices were reported. The most preferred inhaler is L-shaped, has dose preparation with capsule insertion and a dose counter, and is reusable. Inhaler profiles A and B had the highest utilities (mean of 1.2533 and 0.9578 respectively) compared to inhaler C (0.6315) and D (0.2200).

Conclusions: This study showed statistically significant results that the strongest drivers of preference in French users of inhalation devices for COPD are shape, dose counter and reusability. Convenience-related characteristics are important to patients and should be taken into account by clinicians prescribing these devices.

Keywords:

• Chronic obstructive pulmonary disease
• COPD
• discrete choice experiment
• patient preference
• inhaler device
• inhaler characteristics
• convenience

Transparency

Declaration of funding

This study was funded by Boehringer Ingelheim. Creativ-Ceutical received professional fees from Boehringer Ingelheim for the conduct of this study.

Author contributions: N.G. led the study, conducted interviews with patients and clinicians, developed the study questionnaire, and contributed to writing the manuscript. C.C., G.D.P. and P.D. contributed to the development of the study questionnaire, gave clinical and methodological input throughout the study, and were involved in the manuscript development. S.A. designed the study methodology, and gave scientific and strategic direction to the project, and input into the manuscript. D.K. carried out the literature review and statistical analyses, and gave input into the manuscript. M.T. provided scientific guidance and reviewed the manuscript. L.L., K.L.L. and M.B. reviewed all materials, gave input throughout the study and reviewed the manuscript.

Declaration of financial/other relationships

N.G., S.A., D.K. and M.T. have disclosed that they are employed by Creativ-Ceutical. C.C., G.D.P. and P.D. have disclosed that they received professional fees from Boehringer Ingelheim for their work in this study. M.B., L.L. and K.L.L. have disclosed that they are employed by Boehringer Ingelheim.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgements

Thank you to Magali Desroches for her assistance with the study and the preparation of the manuscript. Magali Desroches is an employee of Creativ-Ceutical.