Preferences and Stated Adherence for Antibiotic Treatment of Cystic Fibrosis Pseudomonas Infections.

OBJECTIVE: Our objective was to quantify preferences and stated adherence for inhaled antibiotic treatments in cystic fibrosis (CF). METHODS: Adult CF patients and parents of pediatric patients in the US who were members of the Cystic Fibrosis Foundation and who had Pseudomonas aeruginosa at least twice a year completed an online, discrete-choice experiment survey (response rate 4.4 %). Respondents answered five treatment-choice questions evaluating pairs of hypothetical CF treatment profiles. Stated-adherence questions followed two randomly selected treatment-choice questions. Data were analyzed using random-parameters logit (RPL). For a combination of attribute levels, the utility is estimated by summing the relevant attribute-level parameter estimates. For the stated-adherence questions, we tabulated the changes in the percentages of respondents who would be 95 % adherent for various changes in inhaled antibiotic-medication administration features. RESULTS: The final sample was 271 adult patients and 209 parents. Switching from a 30-min nebulizer twice daily to a 10-min dry powder inhaler (DPI) twice daily was 6.3 times more important for patients and 2.0 times more important for parents than an improvement in dry cough side effect from moderate to mild. Stated adherence for respondents was 20-30 % greater for DPIs versus nebulizers. CONCLUSIONS: Lower frequency of administration, shorter administration times for a given device, and milder dry cough appear to improve stated adherence to antibiotic treatment of CF lung infections.

Duke Scholars

Author F. Reed Johnson Population Health Sciences