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中医师对肺癌中医治疗的偏好及共同决策:一项中国的离散选择实验研究

Physician Preferences and Shared-Decision Making for the Traditional Chinese Medicine Treatment of Lung Cancer: A Discrete-Choice Experiment Study in China.

作者信息

Yan Juntao, Wei Yan, Teng Yue, Liu Shimeng, Li Fuming, Bao Shiyi, Ren Yanfeng, Chen Yingyao

机构信息

School of Public Health, Fudan University, Shanghai, People's Republic of China.

National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, People's Republic of China.

出版信息

Patient Prefer Adherence. 2022 Jun 17;16:1487-1497. doi: 10.2147/PPA.S365109. eCollection 2022.

Abstract

BACKGROUND

With progress being made in the treatment of cancer, various clinical and treatment options are being pursued. In China, Traditional Chinese Medicine (TCM) is used widely in the treatment of cancer.

OBJECTIVE

To estimate TCM treatment preferences and SDM mode of physicians in China.

METHODS

This study was conducted among physicians (n=185) from nine tertiary hospitals in China by discrete-choice experiment (DCE) survey and Shared Decision-Making Questionnaire-physician version (SDM-Q-Doc) survey. The DCE was developed with the inclusion of the most relevant attributes at appropriate levels for the TCM treatment of lung cancer. The empirical data analyses of physicians were performed using mixed logit models. Additionally, subgroup analysis was conducted.

RESULTS

In total, 185 respondents completed the questionnaire. All attributes were statistically significant except out-of-pocket costs. Physicians showed the strongest preferences for increasing disease control rate, relieving nausea and vomiting, and reducing the risk of side effects. Most of the physicians (78.38%) self-reported a high willingness to use SDM during the decision-making process. The physicians with a higher SDM-Q-Doc score had more preference for improving all three attributes than those with a lower score. Little variation was found in preferences among the physicians with other sociodemographic characteristics.

CONCLUSION

In China, physicians considered disease control rate as the most essential attribute in the TCM treatment of lung cancer. The physicians in China mainly preferred SDM, and the preference was different according to SDM mode when involving the TCM therapy for patients with lung cancer. The study findings could inform future TCM therapy for lung cancer and promote SDM.

摘要

背景

随着癌症治疗取得进展,人们正在探索各种临床和治疗选择。在中国,中医药被广泛用于癌症治疗。

目的

评估中国医生对中医药治疗的偏好以及共同决策模式。

方法

本研究通过离散选择实验(DCE)调查和共同决策问卷-医生版(SDM-Q-Doc)调查,对来自中国9家三级医院的185名医生进行了研究。DCE的制定纳入了肺癌中医药治疗最相关的属性,并设置了适当的水平。使用混合逻辑模型对医生的实证数据分析。此外,还进行了亚组分析。

结果

共有185名受访者完成了问卷。除自付费用外,所有属性均具有统计学意义。医生对提高疾病控制率、缓解恶心呕吐以及降低副作用风险表现出最强的偏好。大多数医生(78.38%)自我报告在决策过程中使用共同决策的意愿较高。SDM-Q-Doc得分较高的医生比得分较低的医生更倾向于改善所有三个属性。在具有其他社会人口学特征的医生中,偏好差异不大。

结论

在中国,医生认为疾病控制率是肺癌中医药治疗中最重要的属性。中国医生主要倾向于共同决策,在涉及肺癌患者的中医药治疗时,根据共同决策模式的不同偏好也有所不同。研究结果可为未来肺癌的中医药治疗提供参考,并促进共同决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c680/9211799/6d71321a3b30/PPA-16-1487-g0001.jpg

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