US general population food allergy treatment preferences: a discrete choice experiment

Alexis T. Mickle*, Christina E. Ciaccio, Arpamas Seetasith, Karissa M. Johnston, Jessica S. Dunne, Stacey Kowal, Andrea Bever, Stella Ko, Vincent Garmo, Sachin Gupta, Andrew Lloyd, Christopher M. Warren

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To quantify treatment preferences for food allergy management options (oral immunotherapy, biologic therapy, and allergen avoidance), overall and by sociodemographic strata. Methods: A US general population (≥13 years) discrete choice experiment (DCE) was conducted, including the Intolerance of Uncertainty-12 Scale and clinical/demographic questions. Conditional logistic regression analyses were conducted overall and by sociodemographic factors. DCE results were presented as odds ratios (ORs) with 95% confidence intervals (CIs). Results: Participants (n = 294) mean (standard deviation) age was 47 (19.7) years; 48.6% were male. A 1% reduction in risk of having an exposure resulting in a moderate-to-severe reaction was statistically significantly associated with treatment preference (OR: 1.10; CI:1.04–1.16; p < 0.01). Features significantly associated with reduced preference included: a 1% increase in risk of treatment-related, severe anaphylaxis (0.85; 0.74–0.97; p=0.02); a 1% increase in risk of gastrointestinal symptoms (0.99; 0.99–0.99; p < 0.01); daily treatment (vs. every 2–4 weeks; 0.81; 0.72–0.91; p < 0.01); in-clinic administration (vs. at-home; 0.76; 0.66–0.87; p < 0.01); subcutaneous administration (vs. oral; 0.69; 0.61–0.78; p < 0.01); three-hour post-treatment physical activity limitation (0.84; 0.77–0.93; p < 0.01); and one-year life expectancy reduction (0.87; 0.85–0.89; p < 0.01). Rural dwellers favoured at-home use and no activity limits; lower-income respondents preferred convenience (oral, less frequent, and at-home administration). Teens strongly preferred being bite-safe (vs. fully allergic; 2.75; 1.09–6.90; p = 0.03). Conclusion: When making food allergy management decisions, US general population respondents had strong preferences for features related to safety and convenience; however, the magnitude of preferences varied by sociodemographic factors. These findings may be pertinent for population-level health decision makers.

Original languageEnglish (US)
Pages (from-to)269-279
Number of pages11
JournalCurrent Medical Research and Opinion
Volume41
Issue number2
DOIs
StatePublished - 2025

Funding

The authors acknowledge Elizabeth Badillo for providing medical writing support for this manuscript. This study was funded by Genentech, Inc. Medical writing/editorial support was provided by Elizabeth Badillo from Broadstreet HEOR and funded by the study sponsor. Arpamas Seetasith, Stacey Kowal, Stella Ko, Vincent Garmo, and Sachin Gupta are employees of Genentech, Inc. Alexis T. Mickle, Karissa M. Johnston, Jessica S. Dunne, and Andrea Bever are employees of Broadstreet HEOR which was contracted by Genentech, Inc. for the conduct of this study. Andrew Lloyd is a stockholder in Acaster Lloyd Consulting which was paid a fee for his time on this project. Christopher M. Warren reports research support from National Institutes of Health, Genentech, Inc., and Food Allergy Research and Education. Christina Ciaccio reports research support from National Institutes of Health, Genentech, Inc., and Food Allergy Research and Education, has served as an advisor for Siota, Clostrabio, and Genentech, and has been paid to speak by Genentech. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Keywords

  • Food allergy
  • biologic therapy
  • discrete choice experiment
  • general population
  • immunotherapy
  • surveys and questionnaires
  • treatment preferences

ASJC Scopus subject areas

  • General Medicine

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