Abstract
Background: Understanding patient and caregiver preferences for treatment is important for optimizing treatment decisions. Non-stimulant therapies are an alternative treatment option to stimulant therapy for attention-deficit/hyperactivity disorder (ADHD). Guanfacine extended release (GXR) and atomoxetine (ATX) are two non-stimulant medications approved in the United States for the treatment of ADHD.
Objective: To identify non-stimulant ADHD medication attributes important to caregivers/patients.
Methods: US caregivers of ADHD patients (6–17 years) and child/adolescent patients (10–17 years) completed an adaptive conjoint analysis survey. Respondents selected between hypothetical treatments with different attributes. Ordinary least-squares and hierarchical Bayes regression using Sawtooth Software were used to calculate utilities, importance ratings, and preferences.
Results: 483 caregivers (mean age: 41.9 years, standard deviation [SD]: 8.7; 75% female) and 211 children/adolescents (mean age: 14.5 years, SD: 2.2; 70% male) completed the survey. Based on importance ratings, the most influential attributes for both caregivers and children/adolescents were chance of somnolence, efficacy, and for caregivers, effect on oppositionality and black box warning. Most caregivers (95.3%) and children/adolescents (93.8%) preferred GXR over ATX. In several sensitivity analyses in which attribute levels varied, GXR remained the preferred medication with the exception of one scenario.
Conclusions: Children/adolescents and caregivers demonstrated in this study that they can clearly express their preferences for treatment attributes and treatment choices; in this case they preferred GXR to ATX. Patients and caregiver preferences could be useful inputs to the treatment selection decision-making process.
Keywords: caregivers, children/adolescents, medication preferences, adaptive conjoint analysis, attention-deficit/hyperactivity disorder