Flood Emuella M, Bell Kelly F, de la Cruz Marie C, Ginchereau-Sowell France M
a Icon plc, Clinical Outcomes Assessments , Gaithersburg , MD , USA.
b AstraZeneca, Medical Affairs , Fort Washington , PA , USA.
Curr Med Res Opin. 2017 Feb;33(2):261-268. doi: 10.1080/03007995.2016.1253553. Epub 2016 Dec 2.
To identify which treatment attributes are most influential in determining patient preferences for diabetes treatments and explore patient preferences for diabetes drug classes.
US adults with type 1 or type 2 diabetes completed an online adaptive conjoint analysis survey. The survey examined 14 attributes, including efficacy, regimen, and risk of common side effects and rare but serious adverse events. Respondents selected between hypothetical treatments with different attributes. Sawtooth Software, ordinary least-squares regression, and hierarchical Bayes regression were used to calculate utilities (i.e. preference weights), importance ratings, and shares of preference across 13 diabetes drug classes or combination products.
A total of 167 adults (mean age 58 years; 55% female) with type 1 or type 2 diabetes completed the survey. Based on importance ratings, the most influential attributes driving preferences were regimen, risk of diarrhea, weight change, risk of hypoglycemia, and efficacy. Sodium-glucose co-transporter-2 inhibitors (SGLT-2is) were highly preferred in direct comparison to each of the other classes (range: 84.2-99.9%), with the exception of dipeptidyl peptidase-4 inhibitors (DPP-4is); DPP-4is (52.9%) were preferred over SGLT-2is (47.1%).
Although preferences varied across participants, attributes with the greatest likelihood of affecting daily life and routine were generally more influential in determining patient preferences. DPP-4is and SGLT-2is were overwhelmingly preferred over other drug classes, primarily due to favorable regimen and side effect profiles. Understanding patient preferences can help optimize patient-centered treatment and may lead to improved patient satisfaction, adherence, and outcomes.
The primary limitations of this study are that a small sample size of type 1 diabetes patients were included, which may reduce the reliability of the preference estimates, and patients were recruited from a patient panel and may not be representative of patients with diabetes in the US.
确定在决定患者对糖尿病治疗的偏好方面,哪些治疗属性最具影响力,并探究患者对糖尿病药物类别的偏好。
患有1型或2型糖尿病的美国成年人完成了一项在线自适应联合分析调查。该调查考察了14个属性,包括疗效、治疗方案以及常见副作用和罕见但严重不良事件的风险。受访者在具有不同属性的假设治疗方案之间进行选择。使用锯齿软件、普通最小二乘法回归和分层贝叶斯回归来计算效用(即偏好权重)、重要性评级以及13种糖尿病药物类别或联合产品的偏好份额。
共有167名患有1型或2型糖尿病的成年人(平均年龄58岁;55%为女性)完成了调查。根据重要性评级,驱动偏好的最具影响力的属性是治疗方案、腹泻风险、体重变化、低血糖风险和疗效。与其他各类药物相比,钠-葡萄糖协同转运蛋白2抑制剂(SGLT-2i)在直接比较中受到高度青睐(范围:84.2%-99.9%),二肽基肽酶4抑制剂(DPP-4i)除外;DPP-4i(52.9%)比SGLT-2i(47.1%)更受青睐。
尽管不同参与者的偏好存在差异,但最有可能影响日常生活和常规的属性在决定患者偏好方面通常更具影响力。与其他药物类别相比,DPP-4i和SGLT-2i受到压倒性的青睐,主要是因为其治疗方案和副作用特征良好。了解患者偏好有助于优化以患者为中心的治疗,并可能提高患者满意度、依从性和治疗效果。
本研究的主要局限性在于纳入的1型糖尿病患者样本量较小,这可能会降低偏好估计的可靠性,并且患者是从一个患者小组招募的,可能不代表美国的糖尿病患者。