Tinè Fabio
Unità di Gastroenterologia, Ospedali Riuniti Villa Sofia - Cervello, Palermo, Italy.
Patient Prefer Adherence. 2009 Dec 29;3:363-70. doi: 10.2147/ppa.s7684.
Antiviral therapy with peg-interferon and ribavirin induces sustained virus eradication in 40%-80% of patients with chronic hepatitis C virus (HCV). We investigated patient views on their involvement in therapeutic decision making and on the desirability of disease and treatment-related outcomes.
The control preferences and visual analog scales were administered in a pencil and paper format to a series of 45 patients in order to assess their decisional role, preferences for scenarios of HCV disease and antiviral treatment, and estimates of success required to recommend treatment.
The preferred decisional role of patients was passive in 26 (58%), collaborative in 12 (27%) and active in 7 (15%). Median preference scores ranged from 0.30 to 0.90 for scenarios of disease, from 0.05 to 0.80 for side effects and from 25% to 100% for estimates of benefit to recommend treatment.
Our patients prefer to defer to the doctor the final decision in starting therapy in a context of shared decision making. Reported preferences for HCV scenarios are in the range discussed in the literature. The wide variability in the values attributed to side effects by patients with chronic hepatitis C as well as in expected probabilities of successful treatment suggests a need for decision analysis tailored to the individual patient.
聚乙二醇干扰素和利巴韦林抗病毒治疗可使40%-80%的慢性丙型肝炎病毒（HCV）患者实现病毒持续清除。我们调查了患者对于参与治疗决策以及疾病和治疗相关结果的期望的看法。
采用纸质问卷形式对45例患者进行对照偏好和视觉模拟量表调查，以评估他们的决策角色、对HCV疾病和抗病毒治疗方案的偏好，以及推荐治疗所需的成功概率估计。
患者偏好的决策角色中，26例（58%）为被动，12例（27%）为合作，7例（15%）为主动。疾病方案的中位偏好得分在0.30至0.90之间，副作用的中位偏好得分在0.05至0.80之间，推荐治疗的获益估计概率在25%至100%之间。
在共同决策的背景下，我们的患者更倾向于在开始治疗的最终决策上听从医生的意见。报告的对HCV方案的偏好处于文献中讨论的范围内。慢性丙型肝炎患者对副作用赋予的值以及成功治疗的预期概率存在很大差异，这表明需要针对个体患者进行决策分析。
