Vigneau Cécile, Choukroun Gabriel, Isnard-Bagnis Corinne, Pau David, Sinnasse-Raymond Gilles, Pibre Sophie, Moranne Olivier
Nephrology unit, Rennes University Hospital, 35000 Rennes, France.
Inserm UMR 1088, Nephrology, dialysis, transplantation department, University of Picardie Jules-Verne, Amiens University hospital, 80025 Amiens, France.
Nephrol Ther. 2019 Jun;15(3):152-161. doi: 10.1016/j.nephro.2018.11.009. Epub 2019 Apr 5.
Patient's perception analysis appears recently in numerous studies. Conjoint analysis has been used extensively by market researchers for studying how people value the characteristics of products and services. This technique was used in a clinical study to describe perceptions and preferences of anaemic patients suffering from chronic kidney disease not on dialysis (CKDnd), regarding erythropoietin stimulating agents (ESA).
PERCEPOLIS was a French multicenter prospective non-interventional study designed to describe the relative importance of ESA attributes according to CKDnD patients. Patients fulfilled questionnaires using an electronic device (digital tablet) at baseline and after 6 months under continuous erythropoietin receptor activator (CERA) treatment. Choice-based conjoint (CBC) questionnaires were developed with multiple components: 7 ESA attributes (2 or 3 levels per attribute), 2 partial profiles per task (2 out of the 7 attributes), and 7 tasks per questionnaire. Analyses were performed according to previous ESA treatment or not.
From 789 analyzed patients, 433 non ESA-naive patients were more than 80% to declare treatment efficacy as the most important expectative in ESA choice process (direct question) but CBC analyses revealed that frequency of injections was more crucial (relative mean weight: ∼30% versus ∼20% for efficacy). Pain at injection site and haemoglobin not exceeding the recommended target were confirmed as important criteria for patients (relative mean weights: ∼15%). No new or unexplained safety signals were noted.
Using CBC design for the first time in a non-interventional ESA study with an electronic Patient Reported Outcome (ePRO) in an elderly population, these data showed that monthly injections and treatment efficacy were key patients' expectations relative to ESAs. CERA efficacy to maintain stable haemoglobin within the recommended range was confirmed in real-life conditions.
患者认知分析最近出现在众多研究中。联合分析已被市场研究人员广泛用于研究人们如何评估产品和服务的特性。该技术被用于一项临床研究，以描述未接受透析的慢性肾脏病贫血患者（非透析慢性肾脏病患者，CKDnd）对促红细胞生成素刺激剂（ESA）的认知和偏好。
PERCEPOLIS是一项法国多中心前瞻性非干预性研究，旨在根据非透析慢性肾脏病患者描述ESA属性的相对重要性。患者在基线时以及接受持续促红细胞生成素受体激活剂（CERA）治疗6个月后，使用电子设备（数字平板电脑）填写问卷。基于选择的联合（CBC）问卷由多个部分组成：7个ESA属性（每个属性2或3个水平）、每个任务2个部分概况（7个属性中的2个）以及每个问卷7个任务。根据之前是否接受过ESA治疗进行分析。
在789名分析患者中，433名非初治ESA患者中超过80%宣称治疗效果是ESA选择过程中最重要的期望（直接提问），但CBC分析显示注射频率更为关键（相对平均权重：约30%对约20%的疗效）。注射部位疼痛和血红蛋白不超过推荐目标被确认为患者的重要标准（相对平均权重：约15%）。未发现新的或无法解释的安全信号。
在老年人群中首次将CBC设计用于一项使用电子患者报告结局（ePRO）的非干预性ESA研究，这些数据表明每月注射和治疗效果是患者对ESA的关键期望。在现实生活条件下证实了CERA在将血红蛋白维持在推荐范围内的疗效。
