Damm Kathrin, Lingner Heidrun, Schmidt Katharina, Aumann-Suslin Ines, Buhr-Schinner Heike, van der Meyden Jochen, Schultz Konrad
Center for Health Economics Research Hannover (CHERH), Leibniz University of Hanover, Member of the German Center for Lung Research (DZL), Otto-Brenner-Str. 7, 30159, Hannover, Germany.
Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany.
Health Econ Rev. 2021 Apr 17;11(1):14. doi: 10.1186/s13561-021-00308-0.
Pulmonary rehabilitation (PR) aims to improve disease control in patients with chronic obstructive pulmonary disease (COPD) and asthma. However, the success of PR-programs depends on the patients' participation and willingness to cooperate. Taking the patients' preferences into consideration might improve both of these factors. Accordingly, our study aims to analyze patients' preferences regarding current rehabilitation approaches in order to deduce and discuss possibilities to further optimize pulmonary rehabilitation.
At the end of a 3 weeks in-house PR, patients' preferences concerning the proposed therapies were assessed during two different time slots (summer 2015 and winter 2015/2016) in three clinics using a choice-based conjoint analysis (CA). Relevant therapy attributes and their levels were identified through literature search and expert interviews. Inclusion criteria were as follows: PR-inpatient with asthma and/or COPD, confirmed diagnosis, age over 18 years, capability to write and read German, written informed consent obtained. The CA analyses comprised a generalized linear mixed-effects model and a latent class mixed logit model.
A total of 542 persons participated in the survey. The most important attribute was sport and exercise therapy. Rehabilitation preferences hardly differed between asthma and COPD patients. Health-related quality of life (HRQoL) as well as time since diagnosis were found to have a significant influence on patients' rehabilitation preferences.
Patients in pulmonary rehabilitation have preferences regarding specific program components. To increase the adherence to, and thus, the effectiveness of rehabilitation programs, these results must be considered when developing or optimizing PR-programs.
肺康复(PR)旨在改善慢性阻塞性肺疾病(COPD)和哮喘患者的疾病控制情况。然而,肺康复项目的成功取决于患者的参与度和合作意愿。考虑患者的偏好可能会改善这两个因素。因此,我们的研究旨在分析患者对当前康复方法的偏好,以便推断并讨论进一步优化肺康复的可能性。
在为期3周的住院肺康复结束时,于2015年夏季和2015/2016年冬季这两个不同时间段,在三家诊所采用基于选择的联合分析(CA)评估患者对所提议治疗方法的偏好。通过文献检索和专家访谈确定相关治疗属性及其水平。纳入标准如下:患有哮喘和/或COPD的肺康复住院患者、确诊、年龄超过18岁、具备读写德语的能力、获得书面知情同意。CA分析包括广义线性混合效应模型和潜在类别混合逻辑模型。
共有542人参与了调查。最重要的属性是运动疗法。哮喘患者和COPD患者的康复偏好几乎没有差异。发现健康相关生活质量(HRQoL)以及确诊后的时间对患者的康复偏好有显著影响。
肺康复患者对特定项目组成部分有偏好。为了提高康复项目的依从性,进而提高其有效性,在制定或优化肺康复项目时必须考虑这些结果。