Berglund Erik, Westerling Ragnar, Sundström Johan, Lytsy Per
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Patient Educ Couns. 2016 Dec;99(12):2005-2011. doi: 10.1016/j.pec.2016.07.028. Epub 2016 Jul 28.
This study aimed to investigate patients' willingness to initiate a preventive treatment and compared two established effect measures to the newly developed Delay of Events (DoE) measure that expresses treatment effect as a gain in event-free time.
In this cross-sectional, randomized survey experiment in the general Swedish population,1079 respondents (response rate 60.9%) were asked to consider a preventive cardiovascular treatment. Respondents were randomly allocated to one of three effect descriptions: DoE, relative risk reduction (RRR), or absolute risk reduction (ARR). Univariate and multivariate analyses were performed investigating willingness to initiate treatment, views on treatment benefit, motivation and importance to adhere and willingness to pay for treatment.
Eighty-one percent were willing to take the medication when the effect was described as DoE, 83.0% when it was described as RRR and 62.8% when it was described as ARR. DoE and RRR was further associated with positive views on treatment benefit, motivation, importance to adhere and WTP.
Presenting treatment effect as DoE or RRR was associated with a high willingness to initiate treatment.
An approach based on the novel time-based measure DoE may be of value in clinical communication and shared decision making.
本研究旨在调查患者开始预防性治疗的意愿，并将两种既定的疗效衡量指标与新开发的事件延迟（DoE）指标进行比较，该指标将治疗效果表示为无事件时间的增加。
在瑞典普通人群的这项横断面随机调查实验中，1079名受访者（回复率60.9%）被要求考虑一种预防性心血管治疗。受访者被随机分配到三种疗效描述之一：DoE、相对风险降低（RRR）或绝对风险降低（ARR）。进行单变量和多变量分析，调查开始治疗的意愿、对治疗益处的看法、坚持治疗的动机和重要性以及为治疗付费的意愿。
当疗效描述为DoE时，81%的人愿意服药；当描述为RRR时，这一比例为83.0%；当描述为ARR时，这一比例为62.8%。DoE和RRR还与对治疗益处、动机、坚持治疗的重要性以及支付意愿持积极看法相关。
将治疗效果描述为DoE或RRR与开始治疗的高意愿相关。
基于新的基于时间的指标DoE的方法可能在临床沟通和共同决策中具有价值。
