1190 OLDER ADULTS’ PREFERENCES FOR OBSTRUCTIVE SLEEP APNEA TREATMENT ELICITED FROM A PILOT DISCRETE CHOICE EXPERIMENT

Older adults’ preferences for aspects of obstructive sleep apnea (OSA) treatments have not been elicited. Discrete choice experiments (DCE) estimate preferences based on economic theory that value is derived from a combination of characteristics or attributes of the goods. We used DCE to elicit OSA treatment preferences and estimate relative weights for treatment attributes. Participants recruited from an academic and a Veterans Affairs medical center were provided 9 treatment scenarios for newly-diagnosed OSA. For each scenario, they compared three options: 2 unlabeled treatment options, which had varying attribute (long-term benefits, short-term benefits, major side effects, and minor side effects) values across the 9 scenarios, and 1 “no treatment” option, which had constant attribute values. Participants selected their preferred option for each scenario. The experiment was repeated two weeks later to estimate test-retest reliability. A multilevel mixed-effects logistic regression model estimated preference weights, and a mixed effects linear regression model with an interaction term assessed differences in the attributes between sessions. 30 individuals (mean age 71 years [range 65–91]; 27 [90%] had OSA) participated. Treatment selection patterns revealed that participants weighted long-term benefits as most important (odds ratio [OR] 2.41, p<.001). Preference weights for other attributes were: short-term benefits (OR 1.41, p<.001), major side effects (1.38, p<.011), and minor side effects (OR 1.37, p<.001). No differences in preferences were found between the two sessions (all p-values > .120). Older adults weighted long-term benefits most strongly and minor side effects least strongly. These results have implications for patient education material aimed at improving acceptance and adherence to OSA therapy among older adults. We also demonstrated that it is feasible to use DCE to elicit individual preferences among older adults. This method could be used to personalize treatment decisions related to OSA. Research reported in this publication was supported by the National Institute On Aging of the National Institutes of Health under Award Number K23AG045937, The Beeson Career Development in Aging Research Award Program (supported by NIA, AFAR, The John A. Hartford Foundation, and The Atlantic Philanthropies), and CTSI grant UL1TR000124UCLA (Clinical and Translational Science Institute).