Lacy Brian E, Yu Jerry, Crowell Michael D
Division of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Section of Gastroenterology and Hepatology, Lebanon, New Hampshire, USA.
Division of Gastroenterology, Mayo Clinic, Scottsdale, Arizona, USA.
Clin Transl Gastroenterol. 2015 Jan 8;6(1):e69. doi: 10.1038/ctg.2014.18.
No medication is approved for the treatment of functional dyspepsia (FD). The risks that patients would be willing to take to cure their FD symptoms are unknown.
FD patients (Rome III criteria) were mailed a questionnaire that assessed demographics, medication use, and prior medication adverse events. Scales to measure FD severity, quality of life, anxiety, depression, impulsiveness, and risk-taking behavior were included. A standard gamble (SG) evaluated willingness to take risks associated with a theoretical FD medication. Data were analyzed using simple descriptive statistics.
One hundred and fourteen responses were analyzed (54.5% response rate). The mean age of the patients was 49.2 years; 84% were women and 96% were white. The mean duration of symptoms was 8.2 years (range 1-38 years). The most bothersome symptom was upper abdominal discomfort (25%), followed by upper abdominal pain (22%) and bloating (15%). Forty percent of respondents rated their FD symptoms as moderate and 31% as mild. Forty-six percent reported a side effect from a prescription medication used to treat FD. When asked about a hypothetical medication that could cure their FD symptoms, 49% of respondents reported that they would accept a mean 12.7% risk of sudden death for a 99% chance of cure.
This prospective study suggests that FD patients are surprisingly willing to take significant risks with a hypothetical medication to cure their symptoms. To counsel patients effectively and assist in the development of informed, preference-based decisions regarding medication therapy, physicians need to elicit and understand FD patients' risk adversity.
尚无药物被批准用于治疗功能性消化不良(FD)。患者为治愈FD症状愿意承担的风险尚不清楚。
向符合罗马III标准的FD患者邮寄一份问卷,该问卷评估人口统计学信息、药物使用情况及既往药物不良事件。问卷还包括用于测量FD严重程度、生活质量、焦虑、抑郁、冲动性和冒险行为的量表。采用标准博弈法(SG)评估患者对一种理论上的FD药物相关风险的接受意愿。使用简单描述性统计方法对数据进行分析。
共分析了114份回复(回复率为54.5%)。患者的平均年龄为49.2岁;84%为女性,96%为白人。症状的平均持续时间为8.2年(范围为1 - 38年)。最困扰的症状是上腹部不适(25%),其次是上腹部疼痛(22%)和腹胀(15%)。40%的受访者将其FD症状评为中度,31%评为轻度。46%的受访者报告曾因用于治疗FD的处方药出现过副作用。当被问及一种可能治愈其FD症状的假设药物时,49%的受访者表示,为了99%的治愈机会,他们愿意接受平均12.7%的猝死风险。
这项前瞻性研究表明,FD患者惊人地愿意为一种假设的药物承担重大风险以治愈其症状。为了有效地为患者提供咨询,并协助做出关于药物治疗的明智的、基于偏好的决策,医生需要了解并理解FD患者的风险偏好。