Mühlbacher A C, Juhnke C, Kaczynski A
Hochschule Neubrandenburg, Institut für Gesundheitsökonomie und Medizinmanagement, Neubrandenburg.
Gesundheitswesen. 2016 Oct;78(10):651-657. doi: 10.1055/s-0035-1548932. Epub 2015 Jun 25.
Neuroendocrine tumours (NET) are relatively rare, usually slow-growing malignant tumours. So far there are no data on the patient preferences/priorities regarding the therapy for NET. This empirical study aimed at the elicitation of patient priorities in the drug treatment of NET. Qualitative patient interviews (N=9) were conducted. To elicit the patient's perspective regarding various treatment aspects of NET a self-administered questionnaire using the Analytical Hierarchy Process (AHP) was developed. The data collection was carried out using paper questionnaires supported by an item response system in a group discussion. To evaluate the patient-relevant outcomes, the eigenvector method was applied. N=24 patients, experts and relatives participated in the AHP survey. In the AHP all respondents had clear priorities for all considered attributes. The attribute "overall survival" was the most significant feature of a drug therapy for all respondents. As in the qualitative interviews, "efficacy attributes" dominated the side effects in the AHP as well. The evaluation of all participants thus showed the attributes "overall survival" (Wglobal:0.418), "progression-free survival" (Wglobal:0.172) and "response to treatment" (Wglobal:0.161) to be most relevant. "Occurrence of abdominal pain" (Wglobal:0.051) was ranked sixth, with "tiredness/fatigue" and "risk of a hypoglycaemia" (Wglobal:0.034) in a shared seventh place. The results thus provide evidence about how much influence a treatment capacity has on therapeutic decisions. Using the AHP major aspects of drug therapy from the perspective of those affected were captured, and positive and negative therapeutic properties could be related against each other. Based on the assessment of the patient's perspective further investigation must elicit patient preferences for NET drug therapy. In the context of a discrete choice experiment or another choice-based method of preference measurement, the results obtained here can be validated and the therapeutic features weighted according to their preferability.
神经内分泌肿瘤(NET)是相对罕见的、通常生长缓慢的恶性肿瘤。到目前为止,尚无关于NET治疗方面患者偏好/优先事项的数据。这项实证研究旨在确定NET药物治疗中患者的优先事项。开展了定性的患者访谈(N = 9)。为了了解患者对NET各种治疗方面的看法,开发了一份使用层次分析法(AHP)的自填式问卷。数据收集通过纸质问卷进行,并在小组讨论中由项目反应系统提供支持。为评估与患者相关的结果,应用了特征向量法。24名患者、专家和亲属参与了AHP调查。在AHP中,所有受访者对所有考虑的属性都有明确的优先顺序。对于所有受访者而言,“总生存期”是药物治疗最重要的特征。与定性访谈一样,在AHP中“疗效属性”也比副作用更重要。所有参与者的评估结果显示,“总生存期”(全局权重:0.418)、“无进展生存期”(全局权重:0.172)和“治疗反应”(全局权重:0.161)最为相关。“腹痛发生率”(全局权重:0.051)排名第六,“疲倦/乏力”和“低血糖风险”(全局权重:0.034)并列第七。因此,研究结果证明了治疗能力对治疗决策的影响程度。通过AHP,从患者角度捕捉到了药物治疗的主要方面,并且可以将积极和消极的治疗属性相互关联。基于对患者观点的评估,进一步的研究必须确定患者对NET药物治疗的偏好。在离散选择实验或其他基于选择的偏好测量方法的背景下,此处获得的结果可以得到验证,并且可以根据其偏好程度对治疗特征进行加权。