nach oben

Sleep and Breathing

Erschienen in:

10.01.2022 | Sleep Breathing Physiology and Disorders • Original Article

Patient preferences in obstructive sleep apnea—a discrete choice experiment

verfasst von: Marcel Braun, Sarah Dietz-Terjung, Christian Taube, Christoph Schoebel

Erschienen in: Sleep and Breathing | Ausgabe 4/2022

Einloggen, um Zugang zu erhalten

Abstract

Background

Obstructive sleep apnea (OSA) is one of the most common chronic sleep disorders, which can be treated by different interventions. It is known that acceptance and adherence to these therapies is influenced by a variety of factors. However, there is a limited understanding of patient preferences and decision-making in the context of OSA treatment.

Methods

A discrete choice experiment was conducted on patients with OSA recruited from a tertiary sleep center to evaluate preferences for different treatment attributes. Participants received four different choice tasks with three hypothetical treatments, each defined by seven attributes. A random-effects logit model was used to estimate the influence of the different attributes on the choice decisions. Multivariate logistic regression analysis was carried out to evaluate interactions with medical variables.

Results

In a cohort of 241 subjects with OSA, preferences for treatment attributes and utilities derived from them differed. Most relevant attributes were Reduction in risk of comorbidities, Improvements of daytime sleepiness, Requirement for surgery, and Occurrence of treatment-related side effects. Demographic or medical variables, such as age, gender, or apnea–hypopnea index, did not influence the choice decision. Multivariate logistic regression revealed significant differences in preferences depending on OSA disease history (p = .025) and presence of OSA symptoms (p = .033).

Conclusions

The study identified preferences for attributes of OSA and their utilities from a patient perspective. Relevant differences of preferences in subgroups of patients with OSA were identified, which may be important to consider in selecting appropriate treatments that lead to high rates of acceptance and adherence.

Benjafield AV et al (2019) Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med 7(8):687–698. https://doi.org/10.1016/S2213-2600(19)30198-5CrossRefPubMedPubMedCentral

Dempsey JA, Veasey SC, Morgan BJ, O’Donnell CP (2010) Pathophysiology of sleep apnea. Physiol Rev 90(1):47–112. https://doi.org/10.1152/physrev.00043.2008CrossRefPubMedPubMedCentral

Eckert DJ, Malhotra A (2008) Pathophysiology of adult obstructive sleep apnea. Proc Am Thorac Soc 5(2):144–153. https://doi.org/10.1513/pats.200707-114MGCrossRefPubMedPubMedCentral

Fietze, I et al (2018) Prevalence and association analysis of obstructive sleep apnea with gender and age differences - Results of SHIP-Trend. J Sleep Res: e12770. https://doi.org/10.1111/jsr.12770

Heinzer R et al (2015) Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med 3(4):310–318. https://doi.org/10.1016/S2213-2600(15)00043-0CrossRefPubMedPubMedCentral

Shepertycky MR, Banno K, Kryger MH (2005) Differences between men and women in the clinical presentation of patients diagnosed with obstructive sleep apnea syndrome. Sleep 28(3):309–314PubMed

Appleton S, Gill T, Taylor A, McEvoy D et al (2018) Influence of gender on associations of obstructive sleep apnea symptoms with chronic conditions and quality of life. Int J Environ Res Public Health 15(5):930. https://doi.org/10.3390/ijerph15050930

Kapsimalis F, Kryger MH (2002) Gender and obstructive sleep apnea syndrome, part 1: Clinical features. Sleep 25(4):412–419CrossRefPubMed

Weaver EM, Woodson BT, Steward DL (2005) Polysomnography indexes are discordant with quality of life, symptoms, and reaction times in sleep apnea patients. Otolaryngol-Head Neck Surg 132(2):255–262CrossRefPubMed

10.

Lopes C, Esteves AM, Bittencourt LRA, Tufik S, Mello MT (2008) Relationship between the quality of life and the severity of obstructive sleep apnea syndrome. Braz J Med Biol Res 41(10):908–913. https://doi.org/10.1590/S0100-879X2008005000036CrossRefPubMed

11.

Lee W, Lee S-A, Ryu HU, Chung Y-S, Kim WS (2016) Quality of life in patients with obstructive sleep apnea: relationship with daytime sleepiness, sleep quality, depression, and apnea severity. Chron Respir Dis 13(1):33–39. https://doi.org/10.1177/1479972315606312CrossRefPubMed

12.

Knauert M, Naik S, Gillespie MB, Kryger M (2015) Clinical consequences and economic costs of untreated obstructive sleep apnea syndrome. W J Otorhinolaryngol Head Neck Surg 1(1):17–27CrossRef

13.

Rich J, Raviv A, Raviv N, Brietzke SE (2012) All-cause mortality and obstructive sleep apnea severity revisited. Otolaryngol Neck Surg 147(3):583–587. https://doi.org/10.1177/0194599812450256CrossRef

14.

Young T et al (2008) Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. Sleep 31(8):1071–1078PubMedPubMedCentral

15.

Bonsignore MR, Baiamonte P, Mazzuca E, Castrogiovanni A, Marrone O (2019) Obstructive sleep apnea and comorbidities: a dangerous liaison. Multidiscip Respir Med 14:8.https://doi.org/10.1186/s40248-019-0172-9

16.

Weaver TE et al (2007) Relationship between hours of CPAP use and achieving normal levels of sleepiness and daily functioning. Sleep 30(6):711–719CrossRefPubMedPubMedCentral

17.

Pavwoski P, Shelgikar AV (2017) Treatment options for obstructive sleep apnea. Neurol Clin Pract 7(1):77–85. https://doi.org/10.1212/CPJ.0000000000000320CrossRefPubMedPubMedCentral

18.

Shapiro GK, Shapiro CM (2010) Factors that influence CPAP adherence: an overview. Sleep Breath 14(4):323–335. https://doi.org/10.1007/s11325-010-0391-yCrossRefPubMed

19.

Park P et al (2017) Influencing factors on CPAP adherence and anatomic characteristics of upper airway in OSA subjects. Medicine (Baltimore) 96(51):e8818. https://doi.org/10.1097/MD.0000000000008818CrossRef

20.

Sweetman A et al (2019) Cognitive and behavioral therapy for insomnia increases the use of continuous positive airway pressure therapy in obstructive sleep apnea participants with comorbid insomnia: a randomized clinical trial. Sleep 42(12):zsz178. https://doi.org/10.1093/sleep/zsz178

21.

Louviere JJ, Lancsar E (2009) Choice experiments in health: the good, the bad, the ugly and toward a brighter future. Health Econ Policy Law 4(4):527–546. https://doi.org/10.1017/S1744133109990193CrossRefPubMed

22.

Samuelson PA (1948) Consumption theory in terms of revealed preference. Economica 15(60):243–253. https://doi.org/10.2307/2549561CrossRef

23.

Kroes EP, Sheldon RJ (1988) Stated preference methods: an introduction. J Transp Econ Policy 22(1):11–25

24.

Hauber JFBOJ (2007) Patient preference methods: a patient-centered evaluation paradigm, Accessed: Dec. 26, 2019. [Online]. Available: https://www.rti.org/publication/patient-preference-methods-patient-centered-evaluation-paradigm

25.

Quaife M, Terris-Prestholt F, Di Tanna GL, Vickerman P (2018) How well do discrete choice experiments predict health choices? A systematic review and meta-analysis of external validity. Eur J Health Econ 19(8):1053–1066. https://doi.org/10.1007/s10198-018-0954-6CrossRefPubMed

26.

Lancsar E, Louviere J (2008) Conducting discrete choice experiments to inform healthcare decision making. Pharmacoeconomics 26(8):661–677. https://doi.org/10.2165/00019053-200826080-00004CrossRefPubMed

27.

Braun M, Dietz-Terjung S, Taube C, Schoebel C Understanding preferences in chronic diseases - importance of treatment attributes differs among patients with obstructive sleep apnea. J Sleep Disord Manag 7(1):033. https://doi.org/10.23937/2572-4053.1510033

28.

Hauber AB et al (2016) Statistical methods for the analysis of discrete choice experiments: a report of the ISPOR Conjoint Analysis Good Research Practices Task Force. Value Health 19(4):300–315. https://doi.org/10.1016/j.jval.2016.04.004CrossRefPubMed

29.

Light M, Owens RL, Schmickl CN, Malhotra A (2019) Precision Medicine for obstructive sleep apnea. Sleep Med Clin 14(3):391–398. https://doi.org/10.1016/j.jsmc.2019.05.005CrossRefPubMedPubMedCentral

30.

Eckert DJ (2018) Phenotypic approaches to obstructive sleep apnoea - new pathways for targeted therapy. Sleep Med Rev 37:45–59. https://doi.org/10.1016/j.smrv.2016.12.003CrossRefPubMed

31.

Krucien N, Gafni A, Pelletier-Fleury N (2015) Empirical testing of the external validity of a discrete choice experiment to determine preferred treatment option: the case of sleep apnea. Health Econ 24(8):951–965. https://doi.org/10.1002/hec.3076CrossRefPubMed

32.

Krucien N, Gafni A, Fleury B, Pelletier-Fleury N (2013) Patients’ with obstructive sleep apnoea syndrome (OSAS) preferences and demand for treatment: a discrete choice experiment. Thorax 68(5):487–488. https://doi.org/10.1136/thoraxjnl-2012-202240CrossRefPubMed

33.

Almeida FR et al (2013) Patient preferences and experiences of CPAP and oral appliances for the treatment of obstructive sleep apnea: a qualitative analysis. Sleep Breath 17(2):659–666. https://doi.org/10.1007/s11325-012-0739-6CrossRefPubMed

34.

Slejko JF, Mattingly TJ, Mullins CD, Perfetto EM, dos Reis S (2019) Future of patients in healthcare evaluation: the patient-informed reference case. Value Health 22(5):545–548. https://doi.org/10.1016/j.jval.2019.02.003CrossRefPubMed

35.

Brouwer R, Logar I, Sheremet O (2017) Choice consistency and preference stability in test-retests of discrete choice experiment and open-ended willingness to pay elicitation formats. Environ Resour Econ 68(3):729–751. https://doi.org/10.1007/s10640-016-0045-zCrossRef

Titel: Patient preferences in obstructive sleep apnea—a discrete choice experiment
verfasst von: Marcel Braun
Sarah Dietz-Terjung
Christian Taube
Christoph Schoebel
Publikationsdatum: 10.01.2022
Verlag: Springer International Publishing
Erschienen in: Sleep and Breathing / Ausgabe 4/2022
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-021-02549-z

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Patient preferences in obstructive sleep apnea—a discrete choice experiment