Values and preferences in asthma patients for health care decision making: a systematic literature review.
2Universidad Javeriana, Colombia
Background: Effective asthma management requires clear communication between the patient and the healthcare provider. Patient values and preferences are the relative importance people place on health outcomes. Decisions for asthma treatments aligned with patient values and preferences may make treatments more readily adhered to.
Objectives: To identify patients' and caregivers' values and preferences for asthma treatment with inhaled corticosteroids (ICS) and to describe the instruments and/or techniques to determine them.
Methods: Paired reviewers independently screened six databases from inception to February 2023. We included quantitative and qualitative studies of patients with asthma or their caregivers, eliciting values and preferences about CSI treatment.
Results: Initially, we identified 25429 studies in our searches. After title and abstract and full-text screening, we identified ten quantitative and ten qualitative that met our inclusion criteria (Figure 1). From the 10 quantitative studies, four studies (40%) implemented a discrete choice approach to elicit utilities, one study (10%) used EQ-5D-5l and visual analogue scales (VAS), three studies (30%) applied questionnaires or surveys), two studies (20%) used discrete choice and willingness to pay (WTP). Regarding the qualitative studies, eight studies (80%) were cross-sectional studies, one (10%) was a focus group study, and one (10%) was an ethnographic interview. Qualitative findings showed with moderate certainty evidence that fears about adverse events were a significant concern when patients and caregivers selected their preferred treatment and patients valued treatments capable of relieving symptoms (Table 1).
Conclusions: From the quantitative studies, we have identified different techniques implemented for eliciting values and preferences in asthma patients receiving ICS. In qualitative studies, we have found five key themes to address patient values and preferences in asthma treatment with ICS. Although we are still finalizing data extraction for quantitative studies, our findings suggest that multiple instruments and themes have been used to determine patients' values and preferences and how patients value the relative importance of the main health status.
Patient, public and/or healthcare consumer involvement: Our systematic review summarizes relevant research evidence about patient values and preferences for asthma treatment with ICS to facilitate the integration of values and preferences in healthcare decision processes.