INTRODUCTION
Atopic dermatitis (AD) is one of the most prevalent inflammatory skin conditions, characterized by recurrent eczema with varying degrees of erythema, pruritus, xerosis, and pain. Pruritus is a cardinal indicator of the severity of the disease in addition to the extent of the rash and the impact on quality of life. Corticosteroids, calcineurin inhibitors, phosphodiesterase-4 inhibitors, and other topical immunosuppressants are first-line pharmacotherapies for active AD. Other therapies include ultraviolet light therapy and systemic oral and injectable immunotherapies.1 Although there are many treatment options, success is limited by poor adherence.2-5 Adherence to both topical medications and biologics for AD decreases over the course of treatment, and adherence to topical medication is especially poor.3 Interventions that improve AD treatment adherence aim to encourage patient-provider collaboration, with a focus on education, early follow-up appointments, and accounting for patient preferences.2,6,7 Patient preference for particular vehicle formulations and patient aversion to adverse effects can be detrimental to adherence and, consequently, treatment outcomes.8,9 Discrete choice experiments (DCEs) are used to assess preferences by requiring patients to choose between medications with different attributes presented during several different scenarios. At the end of each DCE, patient preferences are revealed, and the patient is asked to rank these attributes.10 DCEs require patients to evaluate different characteristics relative to one another.11 These valuations are presented using maximum acceptable risk (MAR) for adverse effects (AEs) and maximum acceptable decrease (MAD) in treatment efficacy. Physicians can use patient values to guide patients in navigating these trade-offs to choose treatments with the greatest likelihood of adherence and treatment success. This literature review examines multiple DCEs to identify trends in patient preferences for AD treatment plans and compare patient and physician preferences.
MATERIALS AND METHODS
A literature search was performed on the PubMed database in February 2023 to identify relevant studies on patient preferences for AD treatments. The keywords used included "discrete choice experiment atopic dermatitis" and "discrete choice experiment eczema". Abstract and full-text screening of the nine retrieved articles were performed to assess whether they met the inclusion criteria for this review. DCEs and primary sources using original research and written in English were included. Six DCEs were included that discussed patient and physician preferences with regard to AD treatments.
