TY - JOUR
T1 - Patient Preferences for the Management of Gastrointestinal Symptoms in Kidney Transplantation
T2 - a Discrete Choice Experiment
AU - Cooper, Tess E.
AU - Dalton, Amy
AU - Kieu, Anh
AU - Gately, Ryan
AU - Bourke, Michael J.
AU - Craig, Jonathan C.
AU - Khalid, Rabia
AU - Lim, Wai H.
AU - Scholes-Robertson, Nicole
AU - Teixeira-Pinto, Armando
AU - Jaure, Allison
AU - Wong, Germaine
AU - Howell, Martin
PY - 2023/10
Y1 - 2023/10
N2 - Introduction: Gastrointestinal (GI) symptoms in kidney transplant are common and debilitating. We aimed to ascertain patients’ preferences for GI symptom management options to help future interventions align with treatment priorities. Methods: A discrete choice experiment was conducted with kidney transplant recipients in 3 Australian nephrology units. A multinomial logit model was used to quantify the preferences and trade-offs between 5 characteristics: cost, formulation, symptom burden, dietary changes, and medication quantities. Results: Seventy patients participated (mean age ± SD: 47 ± 15 years, 56% female), 57% had GI symptoms. Patients preferred interventions that will achieve complete resolution of GI symptoms compared to no improvement (odds ratio [95% confidence interval]: 15.3 [1.80, 129.50]), were delivered as a tablet rather than a sachet (1.6 [1.27, 2.08]), retained their current diet compared to eliminating food groups (6.0 [2.19, 16.27]), reduced medication burden (1.4 [1.06, 1.79]), and had lower costs (0.98 [0.96, 1.00]). Participants would be willing to pay AUD$142.20 [$83.90, $200.40] monthly to achieve complete resolution of GI symptoms or AUD$100.90 [$9.60, $192.10] to have moderate improvement in symptoms. Conclusions: Interventions that are highly effective in relieving all GI symptoms without the need for substantive dietary changes, and in tablet form, are most preferred by kidney transplant recipients.
AB - Introduction: Gastrointestinal (GI) symptoms in kidney transplant are common and debilitating. We aimed to ascertain patients’ preferences for GI symptom management options to help future interventions align with treatment priorities. Methods: A discrete choice experiment was conducted with kidney transplant recipients in 3 Australian nephrology units. A multinomial logit model was used to quantify the preferences and trade-offs between 5 characteristics: cost, formulation, symptom burden, dietary changes, and medication quantities. Results: Seventy patients participated (mean age ± SD: 47 ± 15 years, 56% female), 57% had GI symptoms. Patients preferred interventions that will achieve complete resolution of GI symptoms compared to no improvement (odds ratio [95% confidence interval]: 15.3 [1.80, 129.50]), were delivered as a tablet rather than a sachet (1.6 [1.27, 2.08]), retained their current diet compared to eliminating food groups (6.0 [2.19, 16.27]), reduced medication burden (1.4 [1.06, 1.79]), and had lower costs (0.98 [0.96, 1.00]). Participants would be willing to pay AUD$142.20 [$83.90, $200.40] monthly to achieve complete resolution of GI symptoms or AUD$100.90 [$9.60, $192.10] to have moderate improvement in symptoms. Conclusions: Interventions that are highly effective in relieving all GI symptoms without the need for substantive dietary changes, and in tablet form, are most preferred by kidney transplant recipients.
KW - chronic kidney disease
KW - discrete choice experiment
KW - gastrointestinal symptoms
KW - kidney transplant
UR - http://www.scopus.com/inward/record.url?scp=85169505679&partnerID=8YFLogxK
U2 - 10.1016/j.ekir.2023.07.034
DO - 10.1016/j.ekir.2023.07.034
M3 - Article
AN - SCOPUS:85169505679
SN - 2468-0249
VL - 8
SP - 1978
EP - 1988
JO - Kidney International Reports
JF - Kidney International Reports
IS - 10
ER -
