de Vries Sieta T, de Vries Folgerdiena M, Dekker Thijs, Haaijer-Ruskamp Flora M, de Zeeuw Dick, Ranchor Adelita V, Denig Petra
Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Institute for Transport Studies, University of Leeds, Leeds, United Kingdom.
PLoS One. 2015 Oct 7;10(10):e0139755. doi: 10.1371/journal.pone.0139755. eCollection 2015.
To assess whether patients' willingness to add a blood pressure-lowering drug and the importance they attach to specific treatment characteristics differ among age groups in patients with type 2 diabetes.
Patients being prescribed at least an oral glucose-lowering and a blood pressure-lowering drug completed a questionnaire including a discrete choice experiment. This experiment contained choice sets with hypothetical blood pressure-lowering drugs and a no additional drug alternative, which differed in their characteristics (i.e. effects and intake moments). Differences in willingness to add a drug were compared between patients <75 years (non-aged) and ≥75 years (aged) using Pearson χ²-tests. Multinomial logit models were used to assess and compare the importance attached to the characteristics.
Of the 161 patients who completed the questionnaire, 151 (72%) could be included in the analyses (mean age 68 years; 42% female). Aged patients were less willing to add a drug than non-aged patients (67% versus 84% respectively; P = 0.017). In both age groups, the effect on blood pressure was most important for choosing a drug, followed by the risk of adverse drug events and the risk of death. The effect on limitations due to stroke was only significant in the non-aged group. The effect on blood pressure was slightly more important in the non-aged than the aged group (P = 0.043).
Aged patients appear less willing to add a preventive drug than non-aged patients. The importance attached to various treatment characteristics does not seem to differ much among age groups.
评估2型糖尿病患者中,不同年龄组患者添加降压药物的意愿以及他们对特定治疗特征的重视程度是否存在差异。
正在服用至少一种口服降糖药和一种降压药的患者完成了一份包含离散选择实验的问卷。该实验包含有假设的降压药物和不添加额外药物的选择集,它们在特征(即效果和服用时间)上有所不同。使用Pearson卡方检验比较年龄<75岁(非老年)和≥75岁(老年)患者添加药物意愿的差异。使用多项logit模型评估和比较对各特征的重视程度。
在完成问卷的161名患者中,151名(72%)可纳入分析(平均年龄68岁;42%为女性)。老年患者添加药物的意愿低于非老年患者(分别为67%和84%;P = 0.017)。在两个年龄组中,对血压的影响在选择药物时最为重要,其次是药物不良事件风险和死亡风险。对中风所致功能受限的影响仅在非老年组中显著。非老年组对血压的影响比老年组略为重要(P = 0.043)。
老年患者添加预防性药物的意愿似乎低于非老年患者。不同年龄组对各种治疗特征的重视程度似乎差异不大。