OBJECTIVES: Chronic obstructive pulmonary disease (COPD) is one of the most common and burdensome chronic respiratory diseases. This pilot study aimed to explore the priorities of patients with moderate-to-severe COPD in relation to treatment.
METHODS: Interviews were conducted with 20 patients with self-reported moderate-to-severe COPD. Patients completed a brief best-worst scaling (BWS) exercise comprising 12 questions in which 15 features (benefits, harms, or administration features of a COPD treatment) were presented in sets of 5. On each question, patients indicated the most important and the least important feature when choosing whether to take a treatment. Frequency counts of features selected as the most or least important were used to generate BWS weights for each feature. BWS weights ranged from –1 to +1, with a positive weight reflecting greater importance.
RESULTS: The sample consisted of 11 males and 9 females, whose age range was 48 to 86 years (median: 65 years). BWS weights showed that the most important features were improved ability to perform daily activities (0.49), lung function (0.44), and shortness of breath (0.43). These three features were chosen as the most important in more than 40% of their presentations. Being able to walk further and/or for longer was selected as the most important feature in 33.8% of presentations but the overall BWS weight (0.18) was low because the feature was selected as least important in 16.3% of presentations. Explanations given for the importance of benefit features often were interrelated, suggesting dependency between such outcomes. The least important features were needing a blood test before starting medication (–0.58) and mild skin reaction at injection site (–0.51).
CONCLUSIONS: Positive clinical outcomes were prioritised over harms or administration features of a treatment in this sample. Patients may not differentiate between breathing symptoms and functional ability when evaluating treatments.
