Generating Individual Patient Preferences for the Treatment of Osteoarthritis Using Adaptive Choice-Based Conjoint (ACBC) Analysis

Introduction: To explore how adaptive choice- based conjoint (ACBC) analysis could contribute to shared decision-making in the treatment of individual patients with osteoarthritis (OA). Methods: In-depth case study of three individuals randomly selected from patients with OA participating in an ACBC analysis exercise. Eleven members of a research users' group participated in developing an ACBC task on medication preferences for OA. Individual medication priorities are illustrated by the detailed analysis of ACBC output from three randomly selected patients from the main sample. Results: The case study analysis illustrates individual preferences. Participant l's priority was avoidance of the four high-risk side effects of medication, which accounted for 90% of the importance of all attributes, while the remaining attributes (expected benefit; way of taking medication; frequency; availability) accounted only for 10% of the total influence. Participant 3 was similar to participant 1 but would accept a high risk of one of the side effects if the medication were available by prescription. In contrast, participant 2's priority was the avoidance of Internet purchase of medication; this attribute (availability) accounted for 52% of the importance of all attributes. Conclusions: Individual patients have preferences that likely lead to different medication choices. ACBC has the potential as a tool for physicians to identify individual patient preferences as a practical basis for concordant prescribing for OA in clinical practice. Future research needs to establish whether accurate knowledge of individual patient preferences for treatment attributes and levels translates into concordant behavior in clinical practice.