OBJECTIVES: To systematically review studies using discrete choice experiment (DCE) to determine patients’ preferences for antihyperglycemic medications for managing type 2 diabetes mellitus (T2DM).
METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline was used for this review. Four databases, including Pubmed, Econlit, CIHAHL, and APA PsycInfo, were systematically searched for articles published until October 19, 2020. English-language studies that used DCE to determine patients’ preferences for antihyperglycemic medications for patients with T2DM were included.
RESULTS: Of 638 publications, 18 articles were retained for final review. These studies were conducted in the U.S., U.K, European countries, Japan, Canada, Australia, and Singapore between 2009 and 2020. Most studies used web-based surveys with hypothetical treatments for comparison. Glycemic control, gastrointestinal side effects, hypoglycemia, and weight change or control were frequently included as medication attributes in these studies. The number of studies that included the attributes (e.g., cardiovascular and renal outcomes) of newer T2DM medication classes (i.e., sodium-glucose cotransporter-2 inhibitors (SGLT2i) and Glucagon-like peptide 1 receptor agonists (GLP-1 RA)) was limited. Despite a variety of attributes included in these studies, weight change or control (4 out of 15 studies) was identified as the most important attribute, followed by glycemic control (3 out of 16 studies), hypoglycemia (3 out of 16 studies), cardiovascular risk reduction (2 out of 7 studies), mode of administration (2 out of 7 studies), and dosing frequency (2 out of 8 studies), for T2DM patients. The heterogeneity of preference was found among T2DM patients with different sociodemographic characteristics e.g. level of education.
CONCLUSIONS: This review identified various attributes of T2DM medications that were important to patients. These attributes can be utilized to incorporate patients’ preferences in T2DM treatment decision-making. Patients’ preferences for SGLT2i and GLP-1 RA should be examined further.
