Treatment Preferences for Anemia in CKD

NKF 2021 Spring Clinical Meetings

One part of clinical decision making focuses on an understanding of patient and physician preferences regarding various types of treatment. There are few data available examining the value patients and physicians place on specific treatment attributes in anemia in chronic kidney disease. Ember (Yiwei) Lu, PharmD, and colleagues in the United States and the United Kingdom conducted a study to identify treatment attributes of value to patients and physicians and determine the relative importance of those attributes.

Results of the discrete choice experiment (DCE) study were reported during a virtual poster session at the NKF Spring Clinical Meetings 2021. The poster was titled Patients’ and Physicians’ Preferences for Treatment of Anemia of Chronic Kidney Disease: Design Methods of a Discrete Choice Experiment.

The study will include three phases. In phase one, evidence reviews and qualitative interviews were used to identify and describe relevant treatment attributes, supporting the understanding of the symptoms of anemia and their impact. In phase two, pilot interviews with patients and physicians will be used to test the design and validity of the DCE. In the third and final phase, the DCE will be conducted in the United States, Germany, and Japan in a cohort of non-dialysis-dependent and peritoneal dialysis patients, and physicians. A multinominal logit model will be used to analyze responses.

The evidence review identified potential candidate attribute categories of benefit, risk, and convenience. Benefit attributes include items such as anemia symptom relief, number of required monthly blood transfusions, social and emotional impact, need for iron supplements, and life satisfaction/quality of life. Risk attributes include serious adverse events, lung damage, risk of major cardiovascular events, and geriatric complications. Convenience attributes include mode and frequency of administration, out-of-pocket costs, and product storage. The attributes will help inform the design of semi-structured interview guides that will be used in the qualitative interviews to further refine the final attribute list that will be used in collection of the main data.

“This study will address a crucial gap in renal disease research by quantifying, comparing, and contrasting treatment attributes that patients and physicians value. Knowledge of these attributes can benefit future shared decision making in clinical practice,” the researchers said.

Source: Lu E(Y), Okoro T, Amelio J, et al. Patients’ and physicians’ preferences for treatment of anemia in chronic kidney disease: Design methods of a discrete choice experiment. Abstract of a poster presented at the National Kidney Foundation virtual Spring Clinical Meetings 2021 (Abstract #169), April 9. 2021.