Prioritizing Treatment Goals of Patients Diagnosed with Bipolar I Disorder: Results from a US Patient Survey Using Best-Worst Scaling

Abstract: Background Bipolar I disorder (BP-I) patients often have numerous unmet needs. There exists a paucity of evidence on the goals of patients diagnosed with BP-I that could help guide the optimal use of treatment. We sought to prioritize the treatment goals of patients with BP-I and to explore heterogeneity. Methods Patients, ages 18-65 years, with self-reported BP-I and identified via a commercially available US national patient panel, completed an online survey that included a best-worst scaling assessing how they prioritized 16 treatment goals identified through literature and patient engagement. Importance weights were estimated for each treatment goal; segments of patients having different distributions of preferences were identified. Results Of 255 patients who completed the survey, 82% were female, mean age was 46.5 years, and 91% were White. Of these patients, 25% had experiences with long-acting injectable antipsychotic (LAI), 99% oral antipsychotic, 71% mood stabilizer, and 82% antidepressant medications. In aggregate, highest importance was placed on ‘being less impulsive, angry or irritable’; ‘able to feel pleasure/happiness’; ‘reduce frequency between mood episodes’; and ‘staying focused/think clearly’. Reducing side effects was considered relatively less important. Two groups of patients were identified. One group placed more importance on symptom-focused goals, and the other group placed more importance on social functioning focused goals. The latter group was more likely to live with spouse/children and more likely to have been prescribed an LAI. Conclusion Providers should engage patients in conversations about their priorities as a means to identify optimal treatment strategies.Short Description: This study assessed how patients with bipolar I disorder prioritize treatment goals. Using best-worst scaling, findings showed that patients place greatest importance on goals involving greater emotional benefits. It is important for healthcare providers to consider that patients with bipolar I disorder may have different treatment priorities, where some may place greater importance on addressing symptoms and others may place greater importance on improving social functioning.Name of Sponsoring Organization(s): Otsuka Pharmaceutical Development & Commercialization Inc., Princeton, NJ, USA Lundbeck LLC, Deerfield, IL, USA