US general population food allergy treatment preferences: a discrete choice experiment

To quantify treatment preferences for food allergy management options (oral immunotherapy, biologic therapy, and allergen avoidance), overall and by sociodemographic strata. A US general population (≥13 years) discrete choice experiment (DCE) was conducted, including the Intolerance of Uncertainty-12 Scale and clinical/demographic questions. Conditional logistic regression analyses were conducted overall and by sociodemographic factors. DCE results were presented as odds ratios (ORs) with 95% confidence intervals (CIs). Participants (<i>n</i> = 294) mean (standard deviation) age was 47 (19.7) years; 48.6% were male. A 1% reduction in risk of having an exposure resulting in a moderate-to-severe reaction was statistically significantly associated with treatment preference (OR: 1.10; CI:1.04–1.16; <i>p</i> &lt; 0.01). Features significantly associated with reduced preference included: a 1% increase in risk of treatment-related, severe anaphylaxis (0.85; 0.74–0.97; <i>p</i>=0.02); a 1% increase in risk of gastrointestinal symptoms (0.99; 0.99–0.99; <i>p</i> &lt; 0.01); daily treatment (<i>vs.</i> every 2–4 weeks; 0.81; 0.72–0.91; <i>p</i> &lt; 0.01); in-clinic administration (<i>vs.</i> at-home; 0.76; 0.66–0.87; <i>p</i> &lt; 0.01); subcutaneous administration (<i>vs.</i> oral; 0.69; 0.61–0.78; <i>p</i> &lt; 0.01); three-hour post-treatment physical activity limitation (0.84; 0.77–0.93; <i>p</i> &lt; 0.01); and one-year life expectancy reduction (0.87; 0.85–0.89; <i>p</i> &lt; 0.01). Rural dwellers favoured at-home use and no activity limits; lower-income respondents preferred convenience (oral, less frequent, and at-home administration). Teens strongly preferred being bite-safe (<i>vs.</i> fully allergic; 2.75; 1.09–6.90; <i>p</i> = 0.03). When making food allergy management decisions, US general population respondents had strong preferences for features related to safety and convenience; however, the magnitude of preferences varied by sociodemographic factors. These findings may be pertinent for population-level health decision makers.