OBJECTIVES: Asthma is one of the most common and burdensome chronic respiratory diseases. This pilot study aimed to explore the priorities of patients with severe asthma in relation to treatment.
METHODS: Interviews were conducted with 20 patients with self-reported severe asthma. Patients completed a brief best-worst scaling (BWS) exercise comprising 12 questions in which 17 features (benefits, harms, or administration features of an asthma 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 being selected as the most or least important were used to generate BWS weights for each feature. Weights ranged from –1 to +1, with a positive weight reflecting greater importance.
RESULTS: The sample consisted of 6 males and 14 females, whose age range was 23 to 60 years (median: 38 years). BWS weights showed that the most important features were improved shortness of breath (0.33), improved lung function (0.33), and halving the number of moderate asthma attacks (0.27). These features were chosen as the most important in more than 25% of their presentations. Intravenous administration every 4 weeks, halving the number of severe attacks, and self-injection every 2 to 4 weeks also were selected as most important in more than 25% of presentations but the overall BWS weights were relatively low (less than 0.20) because these features were selected as least important in more than 15% of presentations. The least important features were mild skin reaction at injection site (–0.71) and needing a blood test before starting medication (–0.63).
CONCLUSIONS: This sample of patients with asthma prioritised improved breathing, lung function, and reduced moderate asthma attacks over potential harms or administration features. There was significant heterogeneity in preferences for individual features.
