Developing and Testing A Stated-Preference Instrument to Prioritize Treatment Goals Among Patients with Recent Onset Schizophrenia

Younger patients with recent onset schizophrenia may value different treatment goals than patients with longer experience of the disease. We developed and tested a unique stated-preference instrument to prioritize multiple treatment goals among patients with recent onset schizophrenia. A best-worst scaling instrument (BWS) was developed based on a targeted review of the literature. Pre-testing interviews were conducted in the UK, Italy, and Germany among patients with recent onset schizophrenia (aged 18 to 35 who were diagnosed with schizophrenia within the past 5 years). The instrument involves rating the importance of 13 key treatment goals, which were identified based on a review of previous patient preference studies in schizophrenia. Patients completed the online survey in their native language, followed by a cognitive debriefing interview. The interviews were transcribed, and the data were analyzed by two researchers to assess patients’ understanding of the survey and the validity of the content. Five pre-test interviews were conducted in each country. Across the 15 respondents the average age was 31.3 + 4.0 years and 60% were male. All patients understood and could complete the BWS instrument. Probing by interviewers ascertained that patients interpreted the questions appropriately and identified the treatment goals that were most and least important to them. Patient feedback was comparable across countries and confirmed that the 13 key treatment goals assessed were relevant and appropriate. Patients also provided in-depth characterization of each goal from their perspective and the interpretations were consistent. The results of this test confirm that the BWS method and key treatment goals evaluated in this survey are appropriate for use with patients with recent onset schizophrenia. These results will help guide measurement of patient reported outcomes in future studies.