OBJECTIVES: To quantify patient preferences for attention-deficit/hyperactivity disorder (ADHD) treatment attributes among adults in Canada.

METHODS: Treated adults with ADHD were recruited from Dynata’s Canada panel for a web-based discrete choice experiment (08/24/2023–11/04/2023). Treatment attributes and levels were identified based on clinical inputs and published data and included efficacy and safety. Participants’ preferences were estimated using conditional logistic regression model. Willingness to trade-off and attributes’ relative importance were calculated. Overall preferences for treatment profiles approximating centanafadine, lisdexamfetamine, atomoxetine, and viloxazine were estimated using adjusted total utilities. Results were stratified by current treatment status. Sensitivity analyses including only participants who passed validity tests were conducted.

RESULTS: Overall, 323 participants were included (mean age 37.1 years; 51.7% female; 57.6% treated). All attributes had an impact on participants’ preferences (p<0.001). On average, participants were willing to forgo 0.96, 0.91, 0.81, 0.57, and 0.30 percentage points of improvement in ADHD symptoms to achieve 1-percentage-point reduced risks of insomnia, nausea, anxiety, feeling jittery, and dry mouth, respectively. Attributes from high to low relative importance were risk of nausea (28.7%), improvement in ADHD symptoms (25.2%), risks of insomnia (22.9%), anxiety (9.2%), dry mouth (7.6%), and feeling jittery (6.4%). In stratified analysis, treated patients tended to have stronger preference for efficacy, while those untreated tended to have stronger preference for safety. The profile resembling centanafadine had consistently higher adjusted total utilities than comparators, in both the overall sample and subgroups. Sensitivity analyses confirmed the robustness of these results.

CONCLUSIONS: While efficacy was highly valued by patients when making treatment decisions, safety attributes together had a greater relative importance than efficacy alone. Accordingly, ADHD treatments with favorable safety profiles may be preferred by patients. A better understanding of attributes of ADHD treatments valued by patients may help improve shared decision-making, enhance treatment satisfaction, and foster adherence.