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患者和专业人员对西班牙家庭肠内营养产品属性的偏好。一项离散选择实验。

Patients' and professionals' preferences in terms of the attributes of home enteral nutrition products in Spain. A discrete choice experiment.

机构信息

UGC Endocrinología y Nutrición. Hospital Regional Universitario de Málaga/Universidad de Málaga, IBIMA, Málaga, Spain.

Hospital Universitario de Santiago, A Coruña, Spain.

出版信息

Eur J Clin Nutr. 2018 Feb;72(2):272-280. doi: 10.1038/s41430-017-0023-8. Epub 2017 Dec 20.

Abstract

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

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。

结果

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”。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35c0/5842881/f4b5f0eed645/41430_2017_23_Fig1_HTML.jpg

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