How individuals choose medications: Tool development for a discrete choice experiment on eye allergy treatment...

Allergic conjunctivitis affects nearly 40% of the U.S. population, triggered by allergens like pollen or pet dander. Since only 10% of individuals seek medical attention, most rely on over-the-counter (OTC) treatments. The condition can be managed with OTC and prescription (Rx) medications, depending on symptom severity. However, little is known about how individuals decide between treatment approaches.

This study aimed to develop and pilot-test a choice-based conjoint (CBC) tool to measure preferences for 3 treatment approaches: 1) self-selected OTC treatment, 2) pharmacist-advised OTC treatment, and 3) physician-prescribed Rx treatment.

We developed a CBC tool following ISPOR guidelines for conjoint analysis and discrete choice experiments. Key steps included identifying relevant attributes through literature review, validating them through interviews (n = 9), and designing the CBC in Sawtooth Software (Sawtooth Software, Inc) with 10 random and 3 fixed scenarios. Validity testing was conducted with 22 participants to evaluate the tool's ability to capture variability across preference responses.

The CBC tool included 7 attributes: speed of access to treatment, first treatment decision, accuracy of treatment, ease and comfort of administration, cost, time and duration of relief, and side effects, each with 2-3 levels. Validity results showed capture of variability in responses and ability to respond to fixed questions.

This research developed a CBC tool using discrete choice methods to measure how individuals make trade-offs among access, symptom relief, and other factors when selecting treatment approaches for allergic conjunctivitis. The tool offers a replicable framework for measuring individual's treatment management decisions in health care across the health care continuum. This tool will allow measurement of individual preferences for medication choices across the spectrum from self- or pharmacy-assisted OTC, to physician prescribed treatments.