Polanco-Briceno Susan, Glass Daniel, Plunkett Cindy
Deerfield Institute, New York, NY, USA.
Department of Internal Medicine, Metabolism Endocrinology & Diabetes (MEND), University of Michigan, Ann Arbor, MI, USA.
Patient Prefer Adherence. 2016 Dec 14;10:2531-2541. doi: 10.2147/PPA.S119570. eCollection 2016.
This study was designed to assess the awareness and utilization of resources to improve patients' treatment experiences among endocrinologists who currently treat patients with acromegaly.
A total of 4,280 US endocrinologists were randomly selected from the CMS National Plan and Provider Enumeration System and were invited by mail to participate in a 20-minute online survey. In order to qualify, respondents had to be the primary physician making treatment decisions for at least one patient for their acromegaly.
Results are based on responses from 126 physicians from primarily urban and suburban practices, with a median of five acromegaly patients. A total of 70% of patients are currently receiving drug therapy; among these, 91% are on octreotide (51%), lanreotide (29%), or pasireotide (11%), alone or in combination with another therapy. Nearly half of the respondents thought that the impact of patient adherence on therapy outcome for acromegaly was either not very (40%) or not at all (7%) significant. Respondents who believe patient adherence significantly impacts treatment outcome were significantly more likely to discuss automated adherence reminders (50% vs 26%; =0.015), mobile administration programs (57% vs 35%; =0.029), and symptom tracking (72% vs 42%; =0.002). Overall, 44% of respondents routinely recommend education/emotional support programs, and 25% routinely recommend financial assistance programs. Respondents who believe patient adherence significantly impacts treatment outcome generally were more familiar with individual education and emotional support programs compared to those who do not, although they were not more likely to routinely refer patients to any of these resources.
There are unmet needs with respect to increasing awareness among physicians of the importance of patient adherence to therapy, resources available to patients, and how collaboration among patients, nurses, and physicians can improve adherence and overall treatment experiences.
本研究旨在评估目前治疗肢端肥大症患者的内分泌科医生对改善患者治疗体验的资源的认知和利用情况。
从医疗保险和医疗补助服务中心（CMS）的国家计划和提供者枚举系统中随机抽取4280名美国内分泌科医生，并通过邮件邀请他们参加一项20分钟的在线调查。为符合条件，受访者必须是为至少一名肢端肥大症患者做出治疗决策的主治医生。
结果基于126名主要来自城市和郊区医疗机构的医生的回复，这些医生治疗的肢端肥大症患者中位数为5名。目前共有70%的患者正在接受药物治疗；其中，91%的患者单独或与其他疗法联合使用奥曲肽（51%）、兰瑞肽（29%）或帕西瑞肽（11%）。近一半的受访者认为患者依从性对肢端肥大症治疗结果的影响不是很大（40%）或根本没有影响（7%）。认为患者依从性对治疗结果有显著影响的受访者更有可能讨论自动依从性提醒（50%对26%；P=0.015）、移动给药程序（57%对35%；P=0.029）和症状跟踪（72%对42%；P=0.002）。总体而言，44%的受访者经常推荐教育/情感支持项目，25%的受访者经常推荐经济援助项目。与不认为患者依从性对治疗结果有显著影响的受访者相比，认为患者依从性对治疗结果有显著影响的受访者通常更熟悉个人教育和情感支持项目，尽管他们并不更倾向于经常将患者转介至这些资源中的任何一种。
在提高医生对患者坚持治疗的重要性、患者可获得的资源以及患者、护士和医生之间的合作如何改善依从性和总体治疗体验的认识方面，仍存在未满足的需求。
