Table 1

Treatment attributes and levels included in the main discrete choice experiment

Treatment attributeDescription of the treatment attribute presented to participantsLevels
Itch reductionEczema (atopic dermatitis) causes your skin to itch. Treatments for eczema (atopic dermatitis) increase the probability of achieving a meaningful reduction in itch severity.2 out of 10 (20%): There is a 20% chance of achieving a meaningful reduction in itch severity (reference level).
4 out of 10 (40%): There is a 40% chance of achieving a meaningful reduction in itch severity.
5 out of 10 (50%): There is a 50% chance of achieving a meaningful reduction in itch severity.
Skin appearanceEczema (atopic dermatitis) affects the way your skin looks due to flaking, redness, swelling, oozing, crusting, bleeding. Treatment for eczema (atopic dermatitis) may improve your skin condition, but different treatments have different impacts. In this survey, we will ask you to consider the chance of achieving clear skin after 16 weeks starting the treatment.1 out of 10 (10%): After taking treatment for 16 weeks, there is a 10% chance you will have clear/almost-clear skin (reference level).
2 out of 10 (20%): After taking treatment for 16 weeks, there is a 20% chance you will have clear/almost-clear skin.
4 out of 10 (40%): After taking treatment for 16 weeks, there is a 40% chance you will have clear/almost-clear skin.
Eye inflammationAll treatments have some risk of negative side effects. Some treatments can cause minor eye infections. You may have swollen eyelids, feel sensitivity to light, feel itching or burning in your eyes or have pink discolouration of the white in your eyes. This can be treated but may require interruption to treatment. Other treatments do not increase your risk of getting an eye inflammation.0 out of 100 (0%): Your treatment does not increase the chance of an eye inflammation.
10 out of 100 (10%): There is a 10% chance of experiencing an eye inflammation.
20 out of 100 (20%): There is a 20% chance of experiencing an eye inflammation (reference level).
Serious infectionsAll treatments have some risk of negative side effects. Some treatments reduce your immune system’s effectiveness at fighting off illness and can result in serious infections, such as pneumonia or blood poisoning, that may require treatment and hospitalisation; you may be hospitalised for around 1 week. There is always a very low risk of serious infection and this low risk may be increased.0 out of 100 (0%): Your treatment does not increase the risk of serious infection.
3 out of 100 (3%): 3 out of 100 people will experience a serious infection.
6 out of 100 (6%): 6 out of 100 people will experience a serious infection (reference level).
Speed of onsetAll medications for eczema (atopic dermatitis) take some time to start working. Some medications will start to work in 2 days, but others can take 1 or 2 weeks.2 days: Your medication will begin to work 2 days after starting the treatment.
1 week: Your medication will begin to work 1 week after starting the treatment.
2 weeks: Your medication will begin to work 2 weeks after starting the treatment (reference level).
Flare managementFor some treatments, your doctor can increase your dose if your symptoms get worse (flare-ups). After the flare is controlled, reducing the dose again may also be an option. However, other treatments cannot be adjusted in this way and you will remain on a fixed dose, even if your symptoms change.Yes: Your doctor can increase or decrease your dose when your eczema (atopic dermatitis) gets worse or improves.
No: Your doctor cannot increase or decrease your dose when your eczema (atopic dermatitis) gets worse or improves (reference level).
Long-term disease managementSome treatments for eczema (atopic dermatitis) need to be used continuously, without the option to stop and restart therapy when you want. Interruption of treatment, also known as a treatment holiday, can lead to a loss of efficacy over time. This means the therapy may not work as well when you restart treatment. These treatments must be used continuously and cannot be paused. Other treatments can be stopped and restarted (treatment holiday), with no impact on how effective the treatment is. Some treatments should not be used for the long-term, as they can have life threatening side effects, if used for a long period of time.Yes, with the possibility for pauses: Treatment can be taken long-term, and can be paused with no impact on how effective the treatment is.
Yes, without the possibility for pauses: Treatment can be taken long-term, but must be taken continuously for there to be no impact on how effective the treatment is.
Should not be used long-term: You can pause the treatment, but using for the long-term may result in life threatening side effects (reference level).
AdministrationTreatments are not all given/taken in the same way; for instance, some are pills, others are injections or topical creams. In this study we will only be considering pills and injections.Oral pill, one time or two times per day
Injection under the skin, every 2 weeks: This is a subcutaneous injection, below the skin, but above muscle, usually injected into the thigh/stomach area. You can administer the injection yourself or a healthcare professional can administer it. If you choose to administer it yourself, you may need to be trained by a nurse on the injection technique. Treatment is once every 2 weeks (reference level).
Check-upsSome treatments require periodic blood tests taken by your doctor, because although you may not feel any symptoms, some eczema (atopic dermatitis) medications can have a negative impact on your body.Frequent check-ups required: Blood tests every 2 weeks during the initial 3 months of therapy and then monthly if the patient is stable (reference level).
Occasional check-ups required: Blood tests at beginning of treatment, after 12 weeks, and then routinely, as determined by your doctor, while on treatment.
No check-ups required.
  • In each choice task, participants were asked to choose between different treatment options, each composed of one level from each of the attributes. Sensitivity of participants to changes in levels for each attribute were measured relative to the reference level, which is the level that patients least prefer. For example, the reference level for risks is the highest level and for efficacy the reference level is the lowest level.