Use of, satisfaction with, and willingness to switch prescription and over-the-counter treatments for chronic urticaria: an online survey.

BACKGROUND: : Chronic urticaria (hives) affects a sizeable number of people worldwide, perhaps as much as 3%. It is often accompanied by angioedema. The negative effects of urticaria and angioedema, and any adverse effects of treatment, can result in significant patient burden. OBJECTIVE: : To explore patients' use of, preferences for, and willingness to switch from prescription to over-the-counter (OTC) treatments for chronic urticaria. In addition, we compared treatment satisfaction with the treatment used most recently for their chronic urticaria. METHODS: : Data were collected by an online survey using members of international consumer survey panels representative of the general populations in France and Germany. Panelists with urticaria were selected based on answers to screening questions. Respondents were asked, in their native language, questions about their typical course of treatment (prescription vs OTC), satisfaction with treatment, troublesomeness of their typical outbreak, whether their condition had improved or become worse over the past 12 months, and their willingness to try a new treatment if one became available. Descriptive analyses were performed on selected variables. Groups were compared using difference of means tests. Correlations and multiple regressions were performed to assess predictors of satisfaction with treatment and likelihood of switching treatment. RESULTS: : The final study sample consisted of 405 patients. Patients who used prescription treatments were more satisfied and reported greater treatment benefits with their treatment than those using OTC treatments. Patients who felt that their condition had become worse over the past 12 months were more likely to consider switching treatments. Respondents who used Aerius (desloratadine) most recently for treating their symptoms reported greater satisfaction with treatment than did those who used other commonly used prescription treatments most recently. CONCLUSIONS: : These results suggest that prescription treatments for chronic urticaria have a valuable place amongst the treatments offered for this very uncomfortable condition. Moreover, patients expressed preference for prescription treatments in large part because they felt that these treatments work.

Health state utilities for non small cell lung cancer.

BACKGROUND: Existing reports of utility values for metastatic non-small cell lung cancer (NSCLC) vary quite widely and are not all suitable for use in submissions in the UK. The aim of this study was to elicit UK societal based utility values for different stages of NSCLC and different grade III-IV toxicities commonly associated with chemotherapy treatments. Toxicities included neutropenia, febrile neutropenia, fatigue, diarrhoea, nausea and vomiting, rash and hair loss. METHODS: Existing health state descriptions of metastatic breast cancer were revised to make them suitable as descriptions of metastatic NSCLC patients on second-line treatment. The existing health states were used in cognitive debrief interviews with oncologists (n = 5) and oncology specialist nurses (n = 5). Changes were made as suggested by the clinical experts. The resulting health states (n = 17) were piloted and used in a societal based valuation study (n = 100). Participants rated half of the total health states in a standard gamble interview to derive health state utility scores. Data were analysed using a mixed model analysis. RESULTS: Each health state described the symptom burden of disease and impact on different levels of functioning (physical, emotional, sexual, and social). The disutility related to each disease state and toxicity was estimated and were combined to give health state values. All disease states and toxicities were independent significant predictors of utility (p < 0.001). Stable disease with no toxicity (our base state) had a utility value of 0.653. Utility scores ranged from 0.673 (responding disease with no toxicity) to 0.473 for progressive disease. CONCLUSION: This study reflects the value that society place on the avoidance of disease progression and severe toxicities in NSCLC.

Patient-reported outcomes measurements in epilepsy.

This review was designed to explore and review the range of patient-reported outcomes used to assess people with epilepsy. Literature searches were conducted through EMBASE.com and supplemented with hand searching of relevant articles. References obtained through hand searches were compared with EMBASE.com citations until we were confident that the review had reached a point of saturation. The search included English language papers published between January 1997 and March 2007. Searching through EMBASE.com yielded a total of 110 hits and the hand searches identified 35 potentially relevant studies. A total of 61 studies were considered relevant to the current review and were included in the study. Several instruments that have been designed and validated to measure patient-reported outcomes in an epilepsy population are currently being used, including the Quality of Life in Epilepsy (QOLIE)-89 and -31, the Liverpool Seizure Severity Scale and the Washington Psychosocial Seizure Inventory. In addition, the QOLIE-adolescent (QOLIE-AD)-48 and the Adolescent Psychosocial Seizure Inventory have been designed for use with adolescent epileptic patients. We found a paucity of valid condition-specific instruments assessing patient preference and patient satisfaction in this population. Several condition-specific instruments exist to measure patient-reported outcomes in epilepsy, specifically in the areas of health-related quality of life, patient-reported symptoms and psychosocial functioning. However, measures designed to assess other areas of patient-reported outcomes, such as patient preference and satisfaction, are poorly developed.