Dr. Fraenkel is a junior faculty member whose goal is to become an independent investigator in a renowned academic center. The K23 award will provide her with the support and protected time necessary to obtain further formal training, develop her skills and firmly establish her research career. Because of the numbers of persons affected, the public health impact of treating osteoporosis is enormous. However, at the individual patient level, many will not derive any benefit from treatment. Each individual patient's preference for treatment will therefore depend on how he or she weighs the risk of future morbidity and possible mortality over the uncertain risk of long-term toxicity, bothersome adverse effects, and costs related to treatment. Consequently, treatment decisions should be based on physician expertise and explicitly derived patient preferences. The objectives of this proposal are to use Adaptive Conjoint Analysis to: i) examine patient preferences for specific pharmaceutical agents, ii) determine the amount of added benefit patients require before accepting the administration (i.e. daily subcutaneous injections) and costs associated with parathyroid hormone, and iii) estimate how the availability of an extremely convenient option (e.g.: once yearly bisphosphonate) would impact on patient preferences and the market share of osteoporosis medications. The data derived from this study will demonstrate patients' strength of preference for available and promising new therapies, the influence of specific treatment characteristics on choice, and the reasons underlying individual patient's preferences. They will also assess how patient sociodemographic characteristics, self-reported health status, and health beliefs relate to treatment preferences; and determine whether patients and their treating physicians consider ACA to be an acceptable tool to elicit preferences in clinical practice. Measurement of patient preferences in patients at the actual time of decision-making is an important step towards a long-term goal of developing a practical tool to improve incorporation of patient preferences into complex medical decisions.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23AR048826-03
Application #
7100224
Study Section
Special Emphasis Panel (ZAR1-JRL-D (M1))
Program Officer
Mcgowan, Joan A
Project Start
2004-07-01
Project End
2009-06-30
Budget Start
2006-07-01
Budget End
2007-06-30
Support Year
3
Fiscal Year
2006
Total Cost
$131,895
Indirect Cost
Name
Yale University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
043207562
City
New Haven
State
CT
Country
United States
Zip Code
06520
de Achaval, Sofia; Fraenkel, Liana; Volk, Robert J et al. (2012) Impact of educational and patient decision aids on decisional conflict associated with total knee arthroplasty. Arthritis Care Res (Hoboken) 64:229-37
Makris, Una E; Fraenkel, Liana; Han, Ling et al. (2011) Epidemiology of restricting back pain in community-living older persons. J Am Geriatr Soc 59:610-4
Fraenkel, Liana (2011) Uncertainty and patients' preferred role in decision making. Patient Educ Couns 82:130-2
Solomon, Daniel A; Rabidou, Nicole; Kulkarni, Sanjay et al. (2011) Accepting a donor kidney: an evaluation of patients' and transplant surgeons' priorities. Clin Transplant 25:786-93
van Hulst, L T C; Kievit, W; van Bommel, R et al. (2011) Rheumatoid arthritis patients and rheumatologists approach the decision to escalate care differently: results of a maximum difference scaling experiment. Arthritis Care Res (Hoboken) 63:1407-14
Berman, Loren; Curry, Leslie; Goldberg, Carolyn et al. (2011) Pilot testing of a decision support tool for patients with abdominal aortic aneurysms. J Vasc Surg 53:285-92.e1
Fraenkel, Liana; Peters, Ellen (2011) Patients' reaction to the disclosure of rare dreaded adverse events. Patient Educ Couns 84:e1-4
Imaeda, Avlin; Bender, Danielle; Fraenkel, Liana (2010) What is most important to patients when deciding about colorectal screening? J Gen Intern Med 25:688-93
Kievit, Wietske; van Hulst, Laura; van Riel, Piet et al. (2010) Factors that influence rheumatologists' decisions to escalate care in rheumatoid arthritis: results from a choice-based conjoint analysis. Arthritis Care Res (Hoboken) 62:842-7
Fraenkel, Liana (2010) Feasibility of Using Modified Adaptive Conjoint Analysis Importance Questions. Patient 3:209-215

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