UGC Endocrinología y Nutrición. Hospital Regional Universitario de Málaga/Universidad de Málaga, IBIMA, Málaga, Spain.
Hospital Universitario de Santiago, A Coruña, Spain.
Eur J Clin Nutr. 2018 Feb;72(2):272-280. doi: 10.1038/s41430-017-0023-8. Epub 2017 Dec 20.
BACKGROUND/OBJECTIVES: To elicit and compare preferences in terms of the attributes of home enteral nutrition (HEN) among patients and physicians, using a discrete choice experiment (DCE).
SUBJECTS/METHODS: A DCE comprising eight choice scenarios, with six HEN attributes (tolerability, adaptation to comorbidities, nutrition and calories, handling, connections and information; two levels each) was designed. The Relative Importance (RI) for patients and physicians of each attribute was estimated. Sociodemographic and clinical variables, as well as additional questions (n = 8) were compiled to analyze possible explanatory variables and other preferences.
A total of 148 HEN patients (71 needing caregivers to answer on their behalf) and 114 physicians completed the DCE. The most important attributes for patients were adaptation to comorbidities (33% RI), tolerability (33% RI), and nutrition and calories (26% RI). Significantly, younger patients had stronger preferences for tolerability whereas elderly ones (≥75 years) were more concerned about handling. In comparison, physicians gave a higher RI to tolerability, and nutrition and calories compared to patients (p = 0.002). Overall, a higher percentage of physicians answered that HEN characteristics such as easy-handling bags (85.1 vs. 64.9%; p = 0.001), container material (69.3 vs. 57.1%; p = 0.003) or reusable containers (79.8 vs. 70.3%; p = 0.01) were "important" or "very important" compared to patients.
Our findings showed that although patients and physicians have a similar perception about the relevance of different HEN attributes, the relative weight given to each one varies between them. Therefore, both points of view should be considered when choosing a HEN product in order to improve patients' satisfaction and clinical outcomes.
背景/目的：使用离散选择实验（DCE）来引出并比较患者和医生对家庭肠内营养（HEN）属性的偏好。
受试者/方法：设计了一个包含 8 个选择场景的 DCE，其中 HEN 属性（耐受性、适应合并症、营养和热量、处理、连接和信息；每个属性两个水平）有 6 个。估计了每个属性对患者和医生的相对重要性（RI）。编制了社会人口统计学和临床变量以及其他问题（n=8），以分析可能的解释变量和其他偏好。
共有 148 名 HEN 患者（71 名需要护理人员代表他们回答）和 114 名医生完成了 DCE。对患者而言，最重要的属性是适应合并症（33% RI）、耐受性（33% RI）和营养和热量（26% RI）。值得注意的是，年轻患者对耐受性的偏好更强，而老年患者（≥75 岁）则更关注处理问题。相比之下，与患者相比，医生对耐受性和营养与热量的 RI 更高（p=0.002）。总的来说，有更高比例的医生回答说，HEN 特征如易于处理的袋子（85.1%比 64.9%；p=0.001）、容器材料（69.3%比 57.1%；p=0.003）或可重复使用的容器（79.8%比 70.3%；p=0.01）对他们来说是“重要”或“非常重要”。
我们的研究结果表明，尽管患者和医生对不同 HEN 属性的相关性有类似的看法，但他们对每个属性的相对重视程度有所不同。因此，在选择 HEN 产品时，应该考虑到这两个观点，以提高患者的满意度和临床结果。
