Centre de Recherche Médecine, Sciences, Santé, santé Mentale, Société (CERMES3)-UMR 8211-U988, INSERM, Villejuif, France.
Thorax. 2013 May;68(5):487-8. doi: 10.1136/thoraxjnl-2012-202240. Epub 2012 Sep 21.
Despite its high level of effectiveness, initial acceptance of continuous positive airway pressure (CPAP) and regular use in patients with obstructive sleep apneoa syndrome (OSAS) are still an issue. Alternatively, oral appliances (OAs) can be recommended. To improve patient engagement in their treatment, physicians are advised to take into account patient preferences and to share the therapeutic decision. We aimed to determine patients' preferences for OSAS treatment-related attributes, and to predict patients' demand for both CPAP and OAs.
A discrete choice experiment (DCE) was performed in 121 newly diagnosed patients consecutively recruited in a sleep unit.
Regression parameters were the highest for impact on daily life and effectiveness ahead of side effects. In the French context, the demanding probabilities for CPAP and OAs were 60.2% and 36.2%, respectively. They were sensitive to the variation in the amount of out-of-pocket expenses for both CPAP and OAs.
This first DCE in OSAS emphasises the importance to communicate with patients before the implementation of treatment.
尽管持续气道正压通气(CPAP)的有效性很高,但阻塞性睡眠呼吸暂停综合征(OSAS)患者对 CPAP 的初始接受度和常规使用仍然是一个问题。或者,可以推荐使用口腔矫治器(OA)。为了提高患者对治疗的参与度,建议医生考虑患者的偏好,并共同做出治疗决策。我们旨在确定患者对 OSAS 治疗相关属性的偏好,并预测他们对 CPAP 和 OA 的需求。
在睡眠单位连续招募的 121 名新诊断的患者中进行了离散选择实验(DCE)。
对日常生活的影响和治疗效果的回归参数最高,其次是副作用。在法国背景下,CPAP 和 OA 的需求概率分别为 60.2%和 36.2%。它们对 CPAP 和 OA 的自付费用金额的变化很敏感。
这是 OSAS 中的第一个 DCE,强调了在实施治疗之前与患者进行沟通的重要性。