Sims Tracy J, Boye Kristina S, Robinson Susan, Kennedy-Martin Tessa
Eli Lilly and Company, Indianapolis, IN, USA.
KMHO Ltd, Brighton, UK.
Patient Prefer Adherence. 2022 Aug 4;16:1919-1939. doi: 10.2147/PPA.S367046. eCollection 2022.
Understanding the treatment-related attributes influencing medication-taking behaviors in people with type 2 diabetes (T2D) is important for delivery of patient-centered care. This review aimed to identify and summarize studies in which people with T2D (PwD) directly indicated the treatment-related attributes associated with medication-taking behaviors or intentions.
EMBASE and PubMed were searched for studies (Jan 2005-May 2021) reporting the link between PwD-expressed diabetes treatment-related attributes and the decision to initiate, adhere to, or discontinue a T2D medication. Eligible studies reported attributes associated with oral antidiabetes drugs or injectables (not insulin). Studies not explicitly exploring the link between attributes and indicators of behaviors (eg most discrete-choice experiments [DCE] and those interrogating electronic medical records or claims databases) were excluded, as were studies where the link between attribute and behavior came from anyone but the PwD.
Of the 6464 studies identified, 16 were included. Studies were conducted across multiple countries; the USA was most represented (n = 8 studies). The impact of treatment attributes was described on indicators of initiation (n = 3), adherence (n = 12), and discontinuation (n = 4). Some studies evaluated multiple behaviors. PwD perspectives were solicited by structured questionnaires (n = 10), qualitative approaches (n = 4), or DCE explicitly exploring the link to medication-taking behaviors (n = 2). Closed- (n = 9) and open-ended questions (n = 7) were employed. Across studies, several factors including glycemic efficacy (n = 9), weight change (n = 9), dosing frequency (n = 9), hypoglycemia (n = 8), gastrointestinal adverse events (n = 8), regimen complexity (n = 6), route of administration (n = 3), and cardiovascular risk (n = 1) were reported as influencing behaviors, being motivators or barriers to initiation, adherence, or discontinuation.
Several attributes influence how PwD take their medications. Insights gained directly from PwD have the potential to assist stakeholders in making more informed, patient-centered, treatment decisions, thus choosing and managing medications that PwD are comfortable initiating and persisting with over the longer term.
了解影响2型糖尿病（T2D）患者用药行为的治疗相关属性对于提供以患者为中心的护理至关重要。本综述旨在识别和总结那些2型糖尿病患者（PwD）直接指出与用药行为或用药意图相关的治疗相关属性的研究。
检索EMBASE和PubMed数据库，查找2005年1月至2021年5月期间报告PwD表达的糖尿病治疗相关属性与启动、坚持或停用T2D药物决定之间联系的研究。符合条件的研究报告了与口服抗糖尿病药物或注射剂（非胰岛素）相关的属性。未明确探讨属性与行为指标之间联系的研究（如大多数离散选择实验[DCE]以及那些查询电子病历或索赔数据库的研究）被排除，属性与行为之间的联系并非来自PwD本人的研究也被排除。
在识别出的6464项研究中，纳入了16项。研究在多个国家开展；美国的研究数量最多（n = 8项）。描述了治疗属性对启动（n = 3）、坚持（n = 12）和停药（n = 4）指标的影响。一些研究评估了多种行为。通过结构化问卷（n = 10）、定性方法（n = 4）或明确探讨与用药行为联系的DCE（n = 2）征求了PwD的观点。采用了封闭式问题（n = 9）和开放式问题（n = 7）。在各项研究中，包括血糖疗效（n = 9）、体重变化（n = 9）、给药频率（n = 9）、低血糖（n = 8）、胃肠道不良事件（n = 8）、治疗方案复杂性（n = 6）、给药途径（n = 3）和心血管风险（n = 1）等几个因素被报告为影响行为，是启动、坚持或停药的促进因素或障碍。
几个属性会影响PwD的用药方式。直接从PwD那里获得的见解有可能帮助利益相关者做出更明智、以患者为中心的治疗决策，从而选择和管理PwD在较长时期内愿意启动并坚持服用的药物。
