This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Fraenkel, L Articles by Wittink, D R Search for Related Content PubMed PubMed Citation Articles by Fraenkel, L Articles by Wittink, D R Social Bookmarking                         What's this?

Risk-attitude and patient treatment preferences

VA Connecticut Health Care System, West Haven, CT 06516, USA, Department of Medicine, Yale University, New Haven, CT 06520, USA, liana.fraenkel{at}med.va.gov

S T Bogardus, Jr

Department of Medicine, Yale University, New Haven, CT 06520, USA

D R Wittink

School of Management, Yale University, New Haven, CT 06520, USA

Women’s treatment preferences for lupus nephritis vary widely even after adjusting for sociodemographic factors and disease severity. Attitude toward risk may partially explain inter-patient variability in treatment preference. The objective of this study was to examine the association between ‘risk-attitude’and patient treatment preferencesin lupus nephritis. Sixty-five premenopausal women with systemic lupus erythematosus were interviewed. Patient preferences for cyclophosphamide versus azathioprine for the treatment of lupus nephritis were ascertained using an Adaptive Conjoint Analysis questionnaire. Risk-attitude was ascertained by asking patients to choose between a pair of lotteries having the same expected value but differing in spread (the difference between the worst and best outcomes). Respondents preferring the wider spread were classified as relatively more risk-seeking and those preferring the narrower spread were classified as relatively more risk-averse. Twenty-eight percent of respondents were classified as relatively more risk-seeking. Risk-seeking women were more likely to prefer cyclophosphamidefor the treatment of lupus nephritis compared with risk-averse women [least square mean (SD) preference for cyclophosphamide 63 3 among risk-seeking women versus 55 2 among risk-averse women (P < 0.03)]. The association between risk attitude and treatment preference persisted as the probabilities of adverse events were varied to reflect the range of risks reported in the literature. Our results suggest that patients’relative risk-attitudes, as measured by a lottery task, are related to their treatment preferences. Differences in risk-attitude may help explain the inter-patient variability in treatment preferences.

Key Words: lupus nephritis • patient preferences • risk-attitude

Lupus, Vol. 12, No. 5, 370-376 (2003)
DOI: 10.1191/0961203303lu371oa


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?