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影响中国精神分裂症患者及照料者抗精神病药物治疗偏好的因素:一项离散选择实验

Factors Influencing Patient and Caregiver Preferences for Antipsychotic Treatment of Schizophrenia in China: A Discrete Choice Experiment.

作者信息

Zhang Weibo, He Siyuan, Wilson Liam, Foix-Colonier Astrid, Pacou Maud, Zhu Youwei, Zhu Yi, Xue Lili, Wang Yanfeng, Li Junmei, Liu Yanli, Cai Jun

机构信息

Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.

Mental Health Branch, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, People's Republic of China.

出版信息

Patient Prefer Adherence. 2023 Jun 13;17:1421-1430. doi: 10.2147/PPA.S403252. eCollection 2023.

Abstract

PURPOSE

This study aimed to quantify the preferences of Chinese patients with schizophrenia and their caregivers for antipsychotic treatment.

PATIENTS AND METHODS

Patients with schizophrenia (aged 18-35) and their caregivers were recruited via six outpatient mental health clinics in Shanghai, People's Republic of China. In a discrete choice experiment (DCE), participants chose between two hypothetical treatment scenarios that varied regarding the type of treatment, rate of hospitalization, severity of positive symptoms, treatment cost and rates of improvement in daily and social functioning. Data for each group were analyzed using the modelling approach that yielded the lower deviance information criterion. The relative importance score (RIS) for each treatment attribute was also determined.

RESULTS

A total of 162 patients and 167 caregivers participated. Frequency of hospital admission was the most important treatment attribute for patients (average scaled RIS=27%), followed by mode and frequency of treatment administration (24%). Improvement in ability to carry out daily activities (8%) and improvement in social functioning (8%) were least important. Patients in full-time employment placed more importance on the frequency of hospital admission than unemployed patients (p<0.01). Frequency of hospital admission was also the most important attribute for caregivers (RIS=33%), followed by improvement in positive symptoms (20%), while improvement in daily activities (7%) was the least important.

CONCLUSION

Patients with Schizophrenia in China prefer treatments that help reduce the number of times they are admitted to hospital, as do their caregivers. These results may bring insight for physicians and health authorities in China regarding the treatment characteristics that patients value the most.

摘要

目的

本研究旨在量化中国精神分裂症患者及其照料者对抗精神病药物治疗的偏好。

患者与方法

通过中华人民共和国上海的六家门诊心理健康诊所招募了年龄在18 - 35岁之间的精神分裂症患者及其照料者。在一项离散选择实验(DCE)中,参与者在两种假设的治疗方案之间进行选择,这两种方案在治疗类型、住院率、阳性症状严重程度、治疗成本以及日常和社会功能改善率等方面存在差异。使用产生较低偏差信息准则的建模方法对每组数据进行分析。还确定了每个治疗属性的相对重要性得分(RIS)。

结果

共有162名患者和167名照料者参与。住院频率是患者最重要的治疗属性(平均标化RIS = 27%),其次是治疗给药方式和频率(24%)。日常活动能力的改善(8%)和社会功能的改善(8%)最不重要。全职工作的患者比失业患者更重视住院频率(p<0.01)。住院频率也是照料者最重要的属性(RIS = 33%),其次是阳性症状的改善(20%),而日常活动的改善(7%)最不重要。

结论

中国的精神分裂症患者及其照料者都更喜欢有助于减少住院次数的治疗方法。这些结果可能为中国的医生和卫生当局提供有关患者最看重的治疗特征的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20ef/10276608/932bd2c0256f/PPA-17-1421-g0001.jpg

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