Adult, adolescent, and caregiver preferences for attributes of topical treatments for mild-to-moderate atopic dermatitis: a discrete-choice experiment.

Steven R Feldman, Jacob P Thyssen, Marco Boeri, Robert Gerber, Maureen P Neary, Amy Cha, Brett Hauber, Joseph C Cappelleri, Jason Xenakis, Colton Leach, Joshua Zeichner
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Abstract

Purpose: Topical treatments for mild-to-moderate (MM) atopic dermatitis (AD) include emollients, corticosteroids, calcineurin inhibitors, a Janus kinase inhibitor, and a phosphodiesterase 4 inhibitor, which differ in multiple ways. This study aimed to quantify the conditional relative importance (CRI) of attributes of topical treatments for MM AD among adult and adolescent patients and caregivers of children with MM AD.Materials and methods: A discrete-choice experiment (DCE) survey was administered to US adults and adolescents with MM AD and caregivers of children with MM AD. Each choice task comprised 2 hypothetical topical treatments characterized by efficacy, adverse events, vehicle, and application frequency. Data were analyzed using a random-parameters logit model to calculate the CRI of each attribute.Results and conclusions: 300 adults, 331 adolescents, and 330 caregivers completed the DCE. Avoiding changes in skin color (CRI 29.0) and time until itch improves (26.6) were most important to adults, followed by time until clear/almost clear skin (17.8). Application frequency (3.0) did not have a statistically significant impact on adults' choices. Adolescents were less concerned about changes in skin color than adults or caregivers; caregivers were less concerned about time until clear/almost clear skin than patients. Physicians should consider age-relevant aspects of preferences in treatment discussions with patients and caregivers.

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成人、青少年和护理人员对轻度至中度特应性皮炎外用疗法属性的偏好:离散选择实验。
目的:轻度至中度(MM)特应性皮炎(AD)的局部治疗方法包括润肤剂、皮质类固醇激素、降钙素抑制剂、Janus 激酶抑制剂和磷酸二酯酶 4 抑制剂,它们在多个方面存在差异。本研究旨在量化成年和青少年MM AD患者以及MM AD儿童护理者对MM AD局部治疗属性的条件相对重要性(CRI):对美国成年和青少年MM AD患者以及MM AD患儿的看护者进行了离散选择实验(DCE)调查。每个选择任务包括两种假设的外用治疗方法,其特点是疗效、不良反应、载体和使用频率。采用随机参数对数模型对数据进行分析,以计算每个属性的CRI:300名成人、331名青少年和330名护理人员完成了DCE。对成人来说,避免皮肤颜色变化(CRI 29.0)和瘙痒改善所需时间(26.6)最重要,其次是皮肤变白/基本变白所需时间(17.8)。使用频率(3.0)对成人的选择没有显著的统计学影响。与成人或护理人员相比,青少年对肤色变化的关注度较低;与患者相比,护理人员对皮肤变白/基本变白的时间关注度较低。医生在与患者和护理人员讨论治疗时应考虑与年龄相关的偏好。
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