Evaluating Patients’ Preferences for Asthma Therapy Using a Discrete Choice Experiment

Approximately one in 12 Canadians has asthma, a chronic respiratory disease characterized by airway inflammation and variable airflow obstruction. Previous research into how asthma patients manage their disease has found an over-reliance on short-acting beta-agonists (used as needed to quickly relieve symptoms) and an under-use of inhaled corticosteroids (used regularly to prevent asthma attacks). This treatment pattern has been associated with a higher risk of death related to asthma. The overuse of short-acting beta-agonists appears to be linked to socioeconomic status. Despite receiving all drugs at no cost, asthma patients receiving social assistance are more likely to use greater amounts of short-acting beta-agonists than individuals not needing assistance. Helen McTaggart-Cowan is conducting research aimed at identifying the extent to which patients are willing to trade off the immediate symptom relief of short-acting beta-agonists against the ongoing management achieved with inhaled corticosteroids. She is investigating the relative importance of symptom control, cost, side effect minimization and convenience of treatment in an effort to determine the associations between drug preferences and both socioeconomic status and asthma control status. By identifying the factors that result in inappropriate asthma management, Helen’s research will contribute to improved asthma care and provide a foundation for future work aimed at improving treatment efficacy and compliance.