Mohamed AF, Johnson FR, Hauber AB, Lescrauwaet B, Saylan M. Do patients and physicians have similar preferences for chronic hepatitis B treatment outcomes in Turkey? Flora. 2012 Mar 1;17(1):29-38.

OBJECTIVES: To quantify patient and physician preferences for therapeutic tradeoffs involving efficacy, side-effect risks, and evidence uncertainty in chronic hepatitis B (CHB) treatments.

METHODS: Physicians who treat CHB patients and adult patients with a self-reported physician diagnosis of CHB completed a webenabled, discrete-choice experiment survey in Turkey. Both patients and physicians answered 12 treatment-choice questions. Each question required evaluating a pair of hypothetical CHB medication profiles defined by years the medicine has been studied, probability that patient’s viral load remains undetectable for five years with possible reversal of disease progression, five-year treatment-related risks of a fracture and renal insufficiency, and monthly medication cost. Nestedlogit and random-parameters logit models were used to estimate preference weights for all attribute levels and the mean relative importance of each attribute.

RESULTS: One hundred fifty-nine physicians and 117 patients completed the survey in Turkey. Turkish physicians and patients disagreed on the relative importance of all treatment attributes. Turkish patients ranked years of evidence as the most important attribute, while Turkish physicians ranked risk of renal insufficiency as most important. Turkish physicians were willing to accept a 3.2% smaller increase in fracture risk than patients for an additional year of evidence.

CONCLUSIONS: This is the first study to quantify patient and physician preferences for CHB treatment attributes and the first study to elicit physician and patient preferences for years of evidence. We observe different discrepancies between physician and patient preferences in Turkey. Such discrepancies may interfere with optimal outcomes if not considered in patient-physician interactions.

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