A44-29 Patient Preferences for Triple Therapy Inhalers in Chronic Obstructive Pulmonary Disease: Findings From the US Pneumos Discrete Choice Experiment

Abstract Rationale Inhaled maintenance therapy (individual or combination therapy with long-acting beta agonists, long-acting muscarinic antagonists, and inhaled corticosteroids) is a mainstay of treatment for Chronic Obstructive Pulmonary Disease (COPD). Despite the availability of multiple inhaler options, choosing the most suitable option is complex due to differences in formulation and device types. Patient preferences influence adherence and treatment success, underscoring the importance of aligning therapy choice with patient preferences. Methods A web-based Discrete Choice Experiment (DCE) survey was used to elicit treatment preferences of patients aged 40 years or older with moderate to severe COPD (COPD Assessment Test (CAT) score of 10+) and no severe exacerbations in the past year. Participants completed the DCE and the COPD and Asthma Sleep Impact Scale (CASIS) questionnaire. DCE data were analyzed using a latent class logit model, and posterior probability-based class composition was descriptively assessed. Results N = 178 participants (40% female, median Q1-Q3 age 50 45-59) completed the DCE and were included in analysis. Most (93%) experienced severe sleep disruption from COPD in the past week (mean CASIS score=50.9); 56% had high and 34% very high impact from COPD (mean CAT score=28.3). Latent class analysis identified three classes of patients. The first, largest class, included 52% of participants who more commonly had a very high impact from COPD. They valued improvement in nighttime symptoms the most (relative attribute importance RAI=26.7%). The second class (28% of participants) were older and more common daily rescue medication users. They valued most decreases in mortality risk (RAI=26.2%), exacerbations (RAI=24.3%), and cardiovascular event risk (RAI=24%), followed by improvement in nighttime symptoms (RAI=14%). The third class (20% of participants) were more commonly younger males who reported lower impact from COPD. They focused on convenience in their treatment choices (dosing schedule RAI=33.8%, number of devices RAI=28.8%). Conclusions Reducing nighttime symptoms was the most important triple therapy treatment attribute for most patients with COPD in this study, although many patients were also concerned about mortality and cardiovascular event risks. Providers should discuss nighttime symptom management with their patients and aim to align inhaler recommendations with patient preferences. This abstract is funded by: AstraZeneca