Seston Elizabeth M, Ashcroft Darren M, Griffiths Christopher E M
School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Manchester M13 9PT, England.
Arch Dermatol. 2007 Sep;143(9):1175-9. doi: 10.1001/archderm.143.9.1175.
To examine the extent to which the attributes of a treatment affect patients' choice of treatment for psoriasis and the magnitude and nature of trade-offs between risks and benefits of treatment.
A questionnaire, including a stated-preference, discrete choice experiment, was used to elicit patients' preferences for the treatment of psoriasis.
Dermatology clinics in England.
A total of 126 patients with psoriasis.
Preferences of patients for, and trade-offs between, the 6 attributes of time to moderate (50%) improvement, relapse, and risks of experiencing skin irritation, high blood pressure, liver damage, and skin cancer.
The mean age of respondents was 47.6 years, and the mean duration of psoriasis was 23 years. All 6 attributes were important factors affecting choice of treatment. The results indicated that patients with psoriasis prioritized low risk of skin cancer (beta = -0.054; P < .01) and liver damage (beta = -0.054; P < .01) and preferred treatment that resulted in a shorter time to achieve a moderate improvement (beta = -0.034; P < .01) over a longer time to relapse (beta = 0.028; P < .01). Patients were most willing to wait longer for a treatment to work if the likelihood of skin cancer or liver damage was reduced.
This study shows that treatment attributes influence patients with psoriasis in their choice of treatment. The results of the discrete choice experiment presented herein indicate that most respondents would be willing to trade between different aspects of treatment to achieve improvements in their psoriasis and minimize the risks of adverse events.
探讨治疗的属性在多大程度上影响银屑病患者的治疗选择，以及治疗风险与益处之间权衡的程度和性质。
采用一份包含陈述性偏好、离散选择实验的问卷，以引出患者对银屑病治疗的偏好。
英国的皮肤科诊所。
总共126例银屑病患者。
患者对中度（50%）改善时间、复发、皮肤刺激、高血压、肝损伤和皮肤癌风险这6个属性的偏好，以及这些属性之间的权衡。
受访者的平均年龄为47.6岁，银屑病的平均病程为23年。所有6个属性都是影响治疗选择的重要因素。结果表明，银屑病患者将皮肤癌低风险（β = -0.054；P <.01）和肝损伤低风险（β = -0.054；P <.01）列为优先考虑因素，并且相较于复发时间较长（β = 0.028；P <.01），更倾向于能在较短时间内实现中度改善的治疗（β = -0.034；P <.01）。如果皮肤癌或肝损伤的可能性降低，患者最愿意等待更长时间让治疗起效。
本研究表明治疗属性会影响银屑病患者的治疗选择。本文所呈现的离散选择实验结果表明，大多数受访者愿意在治疗的不同方面进行权衡，以改善银屑病病情并将不良事件风险降至最低。
