What do parents want from their child’s asthma treatment?

BACKGROUND Nearly 5 million children in the United States are affected by asthma, which is more than 5% of the population younger than 18 years. In children four years or younger, the prevalence increased 160% from 1980 to 1994. There are several effective drugs that relieve the symptoms of asthma and others are currently being developed, but even when these medications are prescribed, they may be underutilized because parents fear the possibility of adverse events. Up to now there is no knowledge which are the main drivers of caregiver's preferences for a safe and effective medication for preschool children in general. The study population was caregivers with children aged 4 years or below. Sample size was 42; results were checked by Monte Carlo simulation. MATERIAL AND METHODS FOR A CONJOINT ANALYSIS A STATUS QUO TREATMENT AND HYPOTHETICAL TREATMENT OPTIONS WERE DEFINED BY FOUR ATTRIBUTES: Episode-free days, risk of exacerbation, information available for the long-term impact of the treatment, and out-of-pocket expenses. It was possible to use the status quo as the reference scenario, permitting to couch this ranking in terms of a decision to purchase the product. Relative importances for each product attribute as well as utility estimations for each attribute level were calculated. RESULTS AND DISCUSSION The overall result was that the most important feature for an asthma treatment, in this study, was the attribute of episode-free days. On a scale from 0 to 100 this attribute got the calculated relative importance of 44.2. In contrast to this finding is the relative importance of the attribute EXACERBATION, which only reached 16.2, which is the most unimportant attribute of the attributes offered. Even the variable INFORMATION available on long-term effects in children between 4 years and 14 years of age was more important than the side effects (19.2). Out-of-pocket expenses per month were the second most (relative) important attribute (20.5).