2型糖尿病患者对药物益处的认知及其与使用吸入性胰岛素意愿的关联：患者认知框架模型
Perceived medication benefits and their association with interest in using inhaled insulin in type 2 diabetes: a model of patients' cognitive framework.
作者信息
Peyrot Mark, Rubin Richard R
机构信息
Department of Sociology, Loyola University, MD, USA;
出版信息
Patient Prefer Adherence. 2011;5:255-65. doi: 10.2147/PPA.S18799. Epub 2011 Jun 7.
OBJECTIVE
To examine predictors of patient perceived relevance of different diabetes medication benefits, and to determine how medication benefit ratings of an inhaled insulin were associated with evaluation of, and interest in that inhaled insulin.
METHODS
The study was an Internet survey of a US sample (n = 1094) of adults with type 2 diabetes using different medication regimens. Patients were given a brief description of potential clinical benefits and administration procedures for the inhaled insulin described in this study (based on MannKind Corporation's Technosphere insulin). Measures included indicators of medication benefits, needs and relevance, benefit ratings and overall evaluation of the studied inhaled insulin relative to current medication, and interest in the study medication. Multivariate regression assessed significant (P < 0.05) independent associations, controlling for demographic and disease characteristics.
RESULTS
Relevance of potential medication benefits (avoidance of hyperglycemia, hypoglycemia, weight gain, discomfort/inconvenience) was significantly associated with objective and subjective indicators of patients' needs. Most need indicators were associated only with the specific benefit to which they apply; concerns about weight and lifestyle were associated with multiple benefits. Ratings of the studied inhaled insulin for avoiding postprandial hyperglycemia and discomfort/inconvenience were associated with overall evaluation of and interest in the inhaled insulin described in this study; rating of this medication for avoiding weight gain was associated with overall evaluation ratings.
CONCLUSIONS
Relevance of different potential benefits was based on objective and subjective indicators of need. Perceived efficacy of the inhaled insulin described in this study for avoiding postprandial hyperglycemia and discomfort/inconvenience were the benefits most strongly related to the evaluation of and interest in this medication.
目的
研究患者对不同糖尿病药物益处的感知相关性预测因素，并确定吸入性胰岛素的药物益处评分与对该吸入性胰岛素的评估及兴趣之间的关联。
方法
本研究是一项针对美国1094名使用不同药物治疗方案的2型糖尿病成年患者的网络调查。向患者简要介绍了本研究中吸入性胰岛素（基于曼金德公司的Technosphere胰岛素）的潜在临床益处和给药程序。测量指标包括药物益处、需求和相关性指标、益处评分、相对于当前药物对所研究吸入性胰岛素的总体评估，以及对研究药物的兴趣。多变量回归评估了显著（P<0.05）的独立关联，并对人口统计学和疾病特征进行了控制。
结果
潜在药物益处（避免高血糖、低血糖、体重增加、不适/不便）的相关性与患者需求的客观和主观指标显著相关。大多数需求指标仅与它们所适用的特定益处相关；对体重和生活方式的担忧与多种益处相关。所研究的吸入性胰岛素在避免餐后高血糖和不适/不便方面的评分与对本研究中描述的吸入性胰岛素的总体评估及兴趣相关；该药物在避免体重增加方面的评分与总体评估评分相关。
结论
不同潜在益处的相关性基于需求的客观和主观指标。本研究中描述的吸入性胰岛素在避免餐后高血糖和不适/不便方面的感知疗效是与对该药物的评估及兴趣最密切相关的益处。
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