Related Experiment Video
Updated: Jun 7, 2025

E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Quantifying Pill Disutility Associated With Starting Versus Continuing Cardioprotective Medication: A Randomized
Alexander Chaitoff1, Julie C Lauffenburger1, Nancy Haff1
1Center for Healthcare Delivery Sciences, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Boston, MA (A.C., J.C.L., N.H., K.T.J., N.K.C.).
Background:
Quantifying patient-reported pill disutility is important for understanding the risk-benefit tradeoffs of taking medications. The objective of this study was to quantify and compare the pill disutility associated with starting a new medication and continuing an existing medication for cardiometabolic disease prevention in a sample of older adults in the United States.
Methods:
We enrolled adults aged ≥60 years from an online panel. Respondents completed a survey that included a 2-armed experiment that randomized them to either a starting or a continuing scenario in which they were instructed that their doctor recommended they start or continue, respectively, a daily medication that prevents heart attacks and strokes. Pill disutility was calculated using a time-tradeoff method with time willing to trade obtained via alternating dichotomous choice contingent valuation design. Pill disutility was described within each scenario overall and by subgroups and then compared across scenarios using the Kruskal-Wallis test and multivariable fractional logistic regression.
Results:
A total of 621 respondents with a mean age of 69 years were included in the final analysis. A majority were taking medications (n=84.5%, n=525) and had at least 1 chronic cardiometabolic disease (78.7%, n=489). Pill disutility associated with starting a new medication was 0.0662 (SD, 0.13), while pill disutility associated with continuing an existing medication was 0.0378 (SD, 0.10; P<0.001). Participants randomized to the starting scenario had higher odds of higher pill disutility versus participants randomized to the continuing scenario in both multivariable testing (odds ratio, 1.66 [95% CI, 1.15-2.40]) and across subgroups.
Conclusions:
Pill disutility for a daily cardioprotective medication, when obtained from a sample of older adults utilizing rigorous ascertainment methods, is higher than previously reported, especially with regard to starting the medication. These represent the first estimates that can be used in cost-effectiveness modeling involving both prescribing and deprescribing.
More Related Videos
06:55Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
Published on: January 8, 2020
06:16Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
Related Concept Videos
Dosage Regimen: Fixed Dose
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
Rational Dosage Regimen: Maintenance Dose and Loading Dose
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady...
Dose-Response Relationship: Potency and Efficacy
Time Course of Drug Effect
Drug Dosage Regimen: Overview
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
Desensitization and Tachyphylaxis