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Published in: The Patient - Patient-Centered Outcomes Research 4/2010

01-12-2010 | Original Research Article

Analysis of Patients’ Preferences

Direct Assessment and Discrete-Choice Experiment in Therapy of Adults with Attention-Deficit Hyperactivity Disorder

Authors: Dr Axel C. Mühlbacher, Matthias Nübling

Published in: The Patient - Patient-Centered Outcomes Research | Issue 4/2010

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Abstract

Background: Attention-deficit hyperactivity disorder (ADHD) is a complex neuropsychiatric disorder that affects children and young people, as well as adults. Since ADHD does not produce specific organic characteristics, behavior and preferences are crucial to diagnosis and treatment. Comprehensive therapy concepts should take full account of the needs of the patients.
Objective: To document therapy attributes that are important from the adults’ perspective and to analyze findings from two different valuation approaches used in the same survey.
Methods: A self-administered survey measuring attitudes and preferences was conducted in Germany in 2009 (n = 329). Adult patients (aged ≥18 years) were recruited from all over Germany, with the help of patient advocacy organizations. Attitudes were measured and analyzed using a classic rating scale in 5-point Likert format. Discrete-choice experiment (DCE) scenarios were developed using a fractional factorial design and results were analyzed using random effects logit models.
Results: The aspect of highest importance for the respondents was that social function (job, studies, friendships) was not impaired (coefficient 2.115; standard error 0.111). The next most important in the view of the respondents was achievement of behavioral changes through treatment (coefficient 1.755; standard error 0.110). The ‘drug intake’ aspect was not important in the attitude component rating and not significant in the DCE.
Conclusions: The primary goal of ADHD treatment is by no means the alleviation of core symptoms. Instead, therapy should help enable patients to set and achieve their own objectives. Treatment should enable patients to organize their social participation in everyday life.
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Literature
1.
go back to reference Barkley RA, Fischer M, Smallish L, et al. The persistence of attention-deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder. J Abnorm Psychol 2002; 111(2): 279–89PubMedCrossRef Barkley RA, Fischer M, Smallish L, et al. The persistence of attention-deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder. J Abnorm Psychol 2002; 111(2): 279–89PubMedCrossRef
2.
go back to reference Faraone SV, Biederman J, Spencer T, et al. Attention-deficit/hyperactivity disorder in adults: an overview. Biol Psychiatry 2000; 48(1): 9–20PubMedCrossRef Faraone SV, Biederman J, Spencer T, et al. Attention-deficit/hyperactivity disorder in adults: an overview. Biol Psychiatry 2000; 48(1): 9–20PubMedCrossRef
3.
go back to reference Able SL, Johnston JA, Adler LA, et al. Functional and psychosocial impairment in adults with undiagnosed ADHD. Psychol Med 2007; 37(1): 97–107PubMedCrossRef Able SL, Johnston JA, Adler LA, et al. Functional and psychosocial impairment in adults with undiagnosed ADHD. Psychol Med 2007; 37(1): 97–107PubMedCrossRef
4.
5.
go back to reference Kendall T, Taylor E, Perez A, et al. Diagnosis and management of attention-deficit/hyperactivity disorder in children, young people, and adults: summary of NICE guidance. BMJ 2008 Sep 24; 337: a1239 [online]. Available from URL: http://www.bmj.com/cgi/content/extract/337/sep24_1/ a1239 [Accessed 2010 Aug 25]PubMedCrossRef Kendall T, Taylor E, Perez A, et al. Diagnosis and management of attention-deficit/hyperactivity disorder in children, young people, and adults: summary of NICE guidance. BMJ 2008 Sep 24; 337: a1239 [online]. Available from URL: http://​www.​bmj.​com/​cgi/​content/​extract/​337/​sep24_​1/​ a1239 [Accessed 2010 Aug 25]PubMedCrossRef
6.
go back to reference Taylor E, Döpfner M, Sergeant J, et al. European clinical guidelines for hyperkinetic disorder: first upgrade. Eur Child Adolesc Psychiatry 2004; 13Suppl. 1:I7–30PubMed Taylor E, Döpfner M, Sergeant J, et al. European clinical guidelines for hyperkinetic disorder: first upgrade. Eur Child Adolesc Psychiatry 2004; 13Suppl. 1:I7–30PubMed
7.
go back to reference Wasserstein J. Diagnostic issues for adolescents and adults with ADHD. J Clin Psychol 2005; 61(5): 535–47PubMedCrossRef Wasserstein J. Diagnostic issues for adolescents and adults with ADHD. J Clin Psychol 2005; 61(5): 535–47PubMedCrossRef
8.
go back to reference Biederman J, Mick E, Faraone SV. Age-dependent decline of symptoms of attention deficit hyperactivity disorder: impact of remission definition and symptom type. Am J Psychiatry 2000; 157(5): 816–8PubMedCrossRef Biederman J, Mick E, Faraone SV. Age-dependent decline of symptoms of attention deficit hyperactivity disorder: impact of remission definition and symptom type. Am J Psychiatry 2000; 157(5): 816–8PubMedCrossRef
9.
go back to reference Edel M-A. Epidemiologie der ADHS. In: Edel M-A, Vollmoeller W, editors. Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung bei Erwachsenen. Heidelberg: Springer, 2005: XII, 157 S Edel M-A. Epidemiologie der ADHS. In: Edel M-A, Vollmoeller W, editors. Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung bei Erwachsenen. Heidelberg: Springer, 2005: XII, 157 S
10.
go back to reference Bundesärztekammer (2005) Stellungnahme zur “Aufmerks-amkeitsdefizit-/Hyperaktivitätsstörung (ADHS)” [online]. Available from URL: http://www.bundesaerztekammer. de/downloads/ADHSLang.pdf [Accessed 2010 Aug 18] Bundesärztekammer (2005) Stellungnahme zur “Aufmerks-amkeitsdefizit-/Hyperaktivitätsstörung (ADHS)” [online]. Available from URL: http://​www.​bundesaerztekamm​er.​ de/downloads/ADHSLang.pdf [Accessed 2010 Aug 18]
11.
go back to reference Döpfner M, Steinhausen HC, Coghill D, et al. Cross-cultural reliability and validity of ADHD assessed by the ADHD rating scale in a pan-European study [published erratum appears in Eur Child Adolesc Psychiatry 2009; 18 (3): 194-6]. Eur Child Adolesc Psychiatry 2006; 15Suppl. 1:I46–55PubMedCrossRef Döpfner M, Steinhausen HC, Coghill D, et al. Cross-cultural reliability and validity of ADHD assessed by the ADHD rating scale in a pan-European study [published erratum appears in Eur Child Adolesc Psychiatry 2009; 18 (3): 194-6]. Eur Child Adolesc Psychiatry 2006; 15Suppl. 1:I46–55PubMedCrossRef
12.
go back to reference Polanczyk G, de Lima MS, Horta BL, et al. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry 2007; 164(6): 942–8PubMedCrossRef Polanczyk G, de Lima MS, Horta BL, et al. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry 2007; 164(6): 942–8PubMedCrossRef
13.
go back to reference Harpin VA. The effect of ADHD on the life of an individual, their family, and community from preschool to adult life. Arch Dis Child 2005; 90Suppl. 1: i2–7PubMedCrossRef Harpin VA. The effect of ADHD on the life of an individual, their family, and community from preschool to adult life. Arch Dis Child 2005; 90Suppl. 1: i2–7PubMedCrossRef
14.
go back to reference Miranda A, Jarque S, Rosel J. Treatment of children with ADHD: psychopedagogical program at school versus psychostimulant medication. Psicothema 2006; 18(3): 335–41PubMed Miranda A, Jarque S, Rosel J. Treatment of children with ADHD: psychopedagogical program at school versus psychostimulant medication. Psicothema 2006; 18(3): 335–41PubMed
15.
go back to reference National Institute for Health and Clinical Excellence. Attention deficit hyperactivity disorder: diagnosis and management of ADHD in children, young people and adults [clinical guideline 72]. London: NICE, 2008 [online]. Available from URL: http://www.nice.org.uk/nicemedia/ pdf/CG72NiceGuidelinev3.pdf [Accessed 2010 Aug 18] National Institute for Health and Clinical Excellence. Attention deficit hyperactivity disorder: diagnosis and management of ADHD in children, young people and adults [clinical guideline 72]. London: NICE, 2008 [online]. Available from URL: http://​www.​nice.​org.​uk/​nicemedia/​ pdf/CG72NiceGuidelinev3.pdf [Accessed 2010 Aug 18]
16.
go back to reference Weiss M, Murray C. Assessment and management of attention-deficit hyperactivity disorder in adults. CMAJ 2003; 168(6): 715–22PubMed Weiss M, Murray C. Assessment and management of attention-deficit hyperactivity disorder in adults. CMAJ 2003; 168(6): 715–22PubMed
17.
go back to reference Banaschewski T, Coghill D, Santosh P, et al. Long-acting medications for the hyperkinetic disorders: a systematic review and European treatment guideline. Eur Child Adolesc Psychiatry 2006; 15(8): 476–95PubMedCrossRef Banaschewski T, Coghill D, Santosh P, et al. Long-acting medications for the hyperkinetic disorders: a systematic review and European treatment guideline. Eur Child Adolesc Psychiatry 2006; 15(8): 476–95PubMedCrossRef
18.
go back to reference Cunningham CE, Deal K, Rimas H, et al. Modeling the information preferences of parents of children with mental health problems: a discrete choice conjoint experiment. J Abnorm Child Psychol 2008; 36(7): 1123–38PubMedCrossRef Cunningham CE, Deal K, Rimas H, et al. Modeling the information preferences of parents of children with mental health problems: a discrete choice conjoint experiment. J Abnorm Child Psychol 2008; 36(7): 1123–38PubMedCrossRef
19.
go back to reference Cunningham CE, Deal K, Rimas H, et al. Providing information to parents of children with mental health problems: a discrete choice conjoint analysis of professional preferences. J Abnorm Child Psychol 2009; 37(8): 1089–102PubMedCrossRef Cunningham CE, Deal K, Rimas H, et al. Providing information to parents of children with mental health problems: a discrete choice conjoint analysis of professional preferences. J Abnorm Child Psychol 2009; 37(8): 1089–102PubMedCrossRef
20.
go back to reference Mühlbacher AC, Rudolph I, Lincke HJ, et al. Preferences for treatment of attention-deficit/hyperactivity disorder (ADHD): a discrete choice experiment. BMC Health Serv Res 2009; 9: 149PubMedCrossRef Mühlbacher AC, Rudolph I, Lincke HJ, et al. Preferences for treatment of attention-deficit/hyperactivity disorder (ADHD): a discrete choice experiment. BMC Health Serv Res 2009; 9: 149PubMedCrossRef
21.
go back to reference Ryan M, Gerard K, Amaya-Amaya M, editors. Using discrete choice experiments to value health and health care. The economics of non-market goods and resources series. Vol. 11. Dordrecht: Springer, 2008 Ryan M, Gerard K, Amaya-Amaya M, editors. Using discrete choice experiments to value health and health care. The economics of non-market goods and resources series. Vol. 11. Dordrecht: Springer, 2008
22.
go back to reference Ryan M, Farrar S. Using conjoint analysis to elicit preferences for health care. BMJ 2000; 320: 1530–3PubMedCrossRef Ryan M, Farrar S. Using conjoint analysis to elicit preferences for health care. BMJ 2000; 320: 1530–3PubMedCrossRef
23.
go back to reference Ryan M, Gerard K. Using discrete choice experiments to value health care programmes: current practice and future research reflections. Appl Health Econ Health Policy 2003; 2(1): 55–64PubMed Ryan M, Gerard K. Using discrete choice experiments to value health care programmes: current practice and future research reflections. Appl Health Econ Health Policy 2003; 2(1): 55–64PubMed
24.
go back to reference Ryan M, Hughes J. Using conjoint analysis to assess women’s preferences for miscarriage management. Health Econ 1997; 6(3): 261–73PubMedCrossRef Ryan M, Hughes J. Using conjoint analysis to assess women’s preferences for miscarriage management. Health Econ 1997; 6(3): 261–73PubMedCrossRef
25.
go back to reference McFadden D. Conditional logit analysis of qualitative choice behavior [working paper]. Berkeley (CA): Institute of Urban & Regional Development, University of California, 1973: 199 McFadden D. Conditional logit analysis of qualitative choice behavior [working paper]. Berkeley (CA): Institute of Urban & Regional Development, University of California, 1973: 199
26.
go back to reference Ben-Akiva ME, Lerman SR. Discrete choice analysis: theory and application to travel demand. MIT Press series in transportation studies. Cambridge (MA): MIT Press, 1985 Ben-Akiva ME, Lerman SR. Discrete choice analysis: theory and application to travel demand. MIT Press series in transportation studies. Cambridge (MA): MIT Press, 1985
27.
go back to reference Lancaster K. Consumer demand: a new approach. Columbia studies in economics. New York: Columbia University Press, 1971 Lancaster K. Consumer demand: a new approach. Columbia studies in economics. New York: Columbia University Press, 1971
28.
go back to reference Lancaster KJ. A new approach to consumer theory. Indianapolis (IN): Bobbs-Merrill, 1966 Lancaster KJ. A new approach to consumer theory. Indianapolis (IN): Bobbs-Merrill, 1966
29.
go back to reference Hauber AB. Healthy-years equivalent: wounded but not yet dead. Exp Rev Pharmacoeconomics Outcomes Res 2009; 9(3): 265–70CrossRef Hauber AB. Healthy-years equivalent: wounded but not yet dead. Exp Rev Pharmacoeconomics Outcomes Res 2009; 9(3): 265–70CrossRef
30.
go back to reference Telser H, editor. Nutzenmessung im Gesundheitswesen: die Methode der Discrete-Choice-Experimente. S.v. Forschungsergebnisse. Vol. 78. Hamburg: Kova, 2002 Telser H, editor. Nutzenmessung im Gesundheitswesen: die Methode der Discrete-Choice-Experimente. S.v. Forschungsergebnisse. Vol. 78. Hamburg: Kova, 2002
31.
go back to reference Lancsar E, Louviere J. Conducting discrete choice experiments to inform healthcare decision making: a user’s guide. Pharmacoeconomics 2008; 26(8): 661–78PubMedCrossRef Lancsar E, Louviere J. Conducting discrete choice experiments to inform healthcare decision making: a user’s guide. Pharmacoeconomics 2008; 26(8): 661–78PubMedCrossRef
32.
go back to reference Lancsar E, Louviere J, Flynn T. Several methods to investigate relative attribute impact in stated preference experiments. Soc Sci Med 2007; 64(8): 1738–53PubMedCrossRef Lancsar E, Louviere J, Flynn T. Several methods to investigate relative attribute impact in stated preference experiments. Soc Sci Med 2007; 64(8): 1738–53PubMedCrossRef
33.
go back to reference Mühlbacher AC, Nübling M. Analysis of physicians’ perspective versus patients’ preferences: direct assessment and discrete choice experiments in therapy of multiple myeloma Eur J Health Econ. Epub 2010 Jan 28 Mühlbacher AC, Nübling M. Analysis of physicians’ perspective versus patients’ preferences: direct assessment and discrete choice experiments in therapy of multiple myeloma Eur J Health Econ. Epub 2010 Jan 28
34.
go back to reference Mühlbacher AC, Rudolph I, Lincke HH, et al. Preferences for treatment of attention-deficit/hyperactivity disorder (ADHD): a discrete choice experiment. BMC Health Serv Res 2009 Aug 13; 9: 149PubMedCrossRef Mühlbacher AC, Rudolph I, Lincke HH, et al. Preferences for treatment of attention-deficit/hyperactivity disorder (ADHD): a discrete choice experiment. BMC Health Serv Res 2009 Aug 13; 9: 149PubMedCrossRef
35.
go back to reference Telser H, Becker K, Zweifel P. Validity and reliability of willingness-to-pay estimates: evidence from two overlapping discrete-choice-experiments. Patient 2008; 1(4): 283–93PubMedCrossRef Telser H, Becker K, Zweifel P. Validity and reliability of willingness-to-pay estimates: evidence from two overlapping discrete-choice-experiments. Patient 2008; 1(4): 283–93PubMedCrossRef
36.
go back to reference Mühlbacher AC, Lincke H-J, Nübling M. Evaluating patients’ preferences for multiple myeloma therapy, a discrete-choice-experiment. Psychosoc Med 2008; 5: Doc10PubMed Mühlbacher AC, Lincke H-J, Nübling M. Evaluating patients’ preferences for multiple myeloma therapy, a discrete-choice-experiment. Psychosoc Med 2008; 5: Doc10PubMed
37.
go back to reference Johnson FR, Ozdemir S, Mansfield C, et al. Crohn’s disease patients’ risk-benefit preferences: serious adverse event risks versus treatment efficacy. Gastroenterology 2007; 133(3): 769–79PubMedCrossRef Johnson FR, Ozdemir S, Mansfield C, et al. Crohn’s disease patients’ risk-benefit preferences: serious adverse event risks versus treatment efficacy. Gastroenterology 2007; 133(3): 769–79PubMedCrossRef
38.
go back to reference Johnson FR, Hauber AB, Özdemir S. Using conjoint analysis to estimate healthy-year equivalents for acute conditions: an application to vasomotor symptoms. Value Health 2009; 12(1): 146–52PubMedCrossRef Johnson FR, Hauber AB, Özdemir S. Using conjoint analysis to estimate healthy-year equivalents for acute conditions: an application to vasomotor symptoms. Value Health 2009; 12(1): 146–52PubMedCrossRef
39.
go back to reference Phillips KA, Johnson FR, Maddala T. Measuring what people value: a comparison of ‘attitude’ and ‘preference’ surveys. Health Serv Res 2002; 37(6): 1659–79PubMedCrossRef Phillips KA, Johnson FR, Maddala T. Measuring what people value: a comparison of ‘attitude’ and ‘preference’ surveys. Health Serv Res 2002; 37(6): 1659–79PubMedCrossRef
40.
go back to reference Baumgartner H, Steenkamp J-B. Response styles in marketing research: a cross-national investigation. J Mark Res 2001; 38(2): 143–56CrossRef Baumgartner H, Steenkamp J-B. Response styles in marketing research: a cross-national investigation. J Mark Res 2001; 38(2): 143–56CrossRef
41.
go back to reference Nübling M, Andersen HH, Mühlbacher A, et al. Computation of standard values for physical and mental health scale scores using the SOEP version of SF-12v2. Schmollers Jahrbuch 2007; 127(1): 171–82 Nübling M, Andersen HH, Mühlbacher A, et al. Computation of standard values for physical and mental health scale scores using the SOEP version of SF-12v2. Schmollers Jahrbuch 2007; 127(1): 171–82
42.
go back to reference Flynn TN, Louviere JJ, Peters TJ, et al. Best-worst scaling: what it can do for health care research and how to do it. J Health Econ 2007; 26(1): 171–89PubMedCrossRef Flynn TN, Louviere JJ, Peters TJ, et al. Best-worst scaling: what it can do for health care research and how to do it. J Health Econ 2007; 26(1): 171–89PubMedCrossRef
43.
go back to reference Burgess L. Discrete choice experiments [computer software]. Sydney (NSW): Department of Mathematical Sciences, University of Technology, 2007 Burgess L. Discrete choice experiments [computer software]. Sydney (NSW): Department of Mathematical Sciences, University of Technology, 2007
44.
go back to reference Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academy Press, 2001 Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academy Press, 2001
45.
go back to reference Wasson JH, Johnson DJ, Benjamin R, et al. Patients report positive impacts of collaborative care. J Ambul Care Manage 2006; 29(3): 199–206PubMed Wasson JH, Johnson DJ, Benjamin R, et al. Patients report positive impacts of collaborative care. J Ambul Care Manage 2006; 29(3): 199–206PubMed
Metadata
Title
Analysis of Patients’ Preferences
Direct Assessment and Discrete-Choice Experiment in Therapy of Adults with Attention-Deficit Hyperactivity Disorder
Authors
Dr Axel C. Mühlbacher
Matthias Nübling
Publication date
01-12-2010
Publisher
Springer International Publishing
Published in
The Patient - Patient-Centered Outcomes Research / Issue 4/2010
Print ISSN: 1178-1653
Electronic ISSN: 1178-1661
DOI
https://doi.org/10.2165/11584640-000000000-000009

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