Assessing Patient Preferences for Intestinal Failure Management Using the Time Trade-Off Methodology

Area of Science:

• Gastroenterology
• Health Economics
• Patient-Reported Outcomes

Background:

• Limited management options exist for Type III intestinal failure (IF), with home parenteral nutrition (HPN) as the primary treatment.
• Understanding patient preferences is crucial for improving quality of life for individuals with IF.

Purpose of the Study:

• To compare patient preferences for managing Type III IF using time trade-off (TTO) methodology.
• To identify factors significantly impacting health-related quality of life (HRQoL) in IF patients on HPN.

Main Methods:

• A cross-sectional survey of 19 HPN participants was conducted.
• Health-related quality of life (HRQoL) was measured using the TTO methodology.
• Participants evaluated four treatment scenarios: reduced infections, optimized care, small bowel growth (teduglutide), and intestinal transplantation.

Main Results:

• Optimization of care and small bowel growth (teduglutide) received the lowest median health utility scores (0.5), indicating a higher patient preference.
• Intestinal transplantation had the highest median utility score (1.0), suggesting less willingness for this option.

Conclusions:

• This study is the first to apply TTO methodology to assess treatment preferences in IF patients requiring HPN.
• Patients requiring HPN make deliberate choices regarding treatment options.
• HPN service providers should prioritize optimizing current care, as it is highly valued by patients.