Treatment preferences of patients receiving opioid agonist therapy in spain: a discrete choice experiment

Aim: To explore the preferences of patients with opioid use disorder (OUD) regarding opioid agonist treatment (OAT). Methods: The present study was a descriptive, observational, cross-sectional study in OUD patients on treatment for at least 3 months, using one of the pharmacological options available in Spain: methadone (MTD) tablets, MTD oral solution, sublingual buprenorphine/naloxone (SL BPN/NX) or long-acting injectable buprenorphine (LAIB). A discrete choice experiment (DCE) assessed which medication attributes patients prioritized when selecting a hypothetical ideal treatment for their disease. Results: 128 patients from 10 different addiction centres (AC) participated in this study. Treatment groups were balanced: liquid MTD: 28.1%; LAIB: 25%; SL BPN/NX: 24.2%, and MTD tablets: 22.7%. The mean age of the patients was 51 years, and 80% were men. For the total sample, the frequency of administration (Relative importance [RI]: 42.07%) (monthly/weekly vs. daily), route of administration (RI: 22.12%) (oral/SL vs. injectable), and cost (RI = 19.38%) (no co-payment vs. co-payment) were the most impactful factors. For LAIB patients, frequency of administration was the most preferred attribute ahead of cost (second) and performance of daily activities (third). Administration route in these patients ranked fourth. Preferences for these criteria were equal between MTD and SL BPN/NX. Conclusion: Frequency of administration was the main attribute across all treatment groups. Among patients treated with MTD or SL BPN/NX, route of administration and cost were the second and third most relevant attributes, whereas in LAIB patients, cost and the impact on daily activities ranked second and third, respectively.