Patient preference for COPD treatment inhalers: A Discrete Choice Experiment (DCE) in France – Results of a Pilot Study

Introduction: Poor inhaler adherence is a major challenge in chronic obstructive pulmonary disease (COPD), and understanding drivers of inhaler preferences may contribute to adherence and improve long term outcomes. Aims and objective: To identify and quantify preferences for inhaler attributes in French COPD patients, by using DCE methodology. Methods: Attributes were defined from a literature search, expert and patient interviews. An online DCE with COPD patients aged 40-75, using an inhaler for COPD was conducted. The pilot study included scenarios of two fictitious inhalers described according to the attributes. The COPD Assessment Test and 18 questions on diagnosis, treatment and socio-demographic profile were included. A D-efficient design with zero priors was used. Analyses used a conditional logit model with interactions. Results: Seven inhaler attributes were defined: shape, dose insertion, dose preparation, dose release, dose confirmation, dose counter, and reusability. Twenty-one patients completed the pilot phase, and 5 did cognitive debriefing interviews. The mean CAT score was 27.14 (range 17-40). Results show the most valued characteristics to be dose insertion, dose counter and reusability, with a tendency to prefer fewer dose preparation steps, and reusable inhalers with a dose counter. Conclusion: The pilot results suggest that the selected attributes are relevant to COPD patients in France, and should therefore be taken into account by healthcare professionals considering treatment options. In the full online survey, 150 patients with COPD will be included; will confirm which attributes are most valued for French COPD patients.