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对患者而言什么是重要的?丙肝治疗决策中患者的信息需求。

What's Important to the Patient? Informational Needs of Patients Making Decisions About Hepatitis C Treatment.

作者信息

Evon Donna M, Golin Carol E, Stoica Teodora, Jones Rachel E, Willis Sarah J, Galanko Joseph, Fried Michael W

机构信息

Division of Gastroenterology and Hepatology, University of North Carolina, CB# 7584, 8010 Burnett-Womack, Chapel Hill, NC, 27599, USA.

Department of Medicine, Department of Health Behavior, University of North Carolina, Chapel Hill, NC, USA.

出版信息

Patient. 2017 Jun;10(3):335-344. doi: 10.1007/s40271-016-0207-7.

Abstract

BACKGROUND AND OBJECTIVES

Multiple treatment options with direct-acting antivirals are now available for hepatitis C virus (HCV). Study aims were to understand (1) the informational topics patients want to have to make informed treatment decisions; (2) the importance patients place on each topic; and (3) the topics patients prioritize as most important.

METHODS

We used a mixed-methods study of two samples recruited from an academic liver center. Participants were not currently on treatment. Sample I (n = 45) free listed all informational topics deemed important to decision making. Raw responses were coded into several broad and subcategories. Sample II (n = 38) rated the importance of the subcategories from Sample I and ranked their highest priorities on two surveys, one containing topics for which sufficient research existed to inform patients ('static'), and the other containing topics that would require additional research.

RESULTS

The topics listed by Sample I fell into six broad categories with 17 total subcategories. The most oft-cited informational topics were harms of treatment (100%), treatment benefits (62%), and treatment regimen details (84%). Sample II rated 16 of 17 subcategories as "pretty important' or "extremely important". Sample II prioritized (1) viral cure, (2) long-term survival, and (3) side effects on the survey of topics requiring additional research, and (1) liver disease, (2) lifestyle changes, and (3) medication details on the second survey of the most important static topics patients needed.

CONCLUSIONS

Patients weighed several informational topics to make an informed decision about HCV treatment. These findings lay the groundwork for future patient-centered outcomes research in HCV and patient-provider communication to enhance patients' informed decision making regarding direct-acting antiviral treatment options.

摘要

背景与目的

目前有多种直接作用抗病毒药物可用于治疗丙型肝炎病毒(HCV)。本研究旨在了解:(1)患者为做出明智的治疗决策希望了解的信息主题;(2)患者对每个主题的重视程度;(3)患者认为最重要的优先主题。

方法

我们采用混合方法对从一家学术性肝脏中心招募的两个样本进行研究。参与者目前未接受治疗。样本I(n = 45)自由列出所有被认为对决策重要的信息主题。原始回答被编码为几个宽泛的类别和子类别。样本II(n = 38)对样本I中的子类别重要性进行评分,并在两项调查中对其最高优先级进行排序,一项调查包含有足够研究可告知患者的主题(“静态”主题),另一项调查包含需要额外研究的主题。

结果

样本I列出的主题分为六大类,共17个子类别。最常被提及的信息主题是治疗危害(100%)、治疗益处(62%)和治疗方案细节(84%)。样本II将17个子类别中的16个评为“相当重要”或“极其重要”。在需要额外研究的主题调查中,样本II将(1)病毒治愈、(2)长期生存和(3)副作用列为优先事项;在患者需要了解的最重要静态主题的第二项调查中,样本II将(1)肝脏疾病、(2)生活方式改变和(3)药物细节列为优先事项。

结论

患者权衡了多个信息主题,以便就HCV治疗做出明智决策。这些发现为未来以患者为中心的HCV结局研究以及患者与医疗服务提供者的沟通奠定了基础,以增强患者对直接作用抗病毒治疗方案的明智决策能力。

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