Sen Rohini, Shields Alan L, Atsuda Koichiro
Adelphi Values, Boston, MA, USA.
Kitasato University, Kanagawa, Japan.
J Health Econ Outcomes Res. 2016 Mar 18;4(1):55-66. doi: 10.36469/9826. eCollection 2016.
Among several factors that impair adherence to available therapies in type 2 diabetes mellitus (T2DM) is the complexity of the dosing regimen. Moreover, the value of a once-weekly (QW) administration of oral medications for T2DM compared to once, twice, or thrice daily (QD, BID, TID) regimens is unclear. This study aims to identify subgroups and patient characteristics correlated with a preference for QW dosing compared to daily dosing using survey-based methods. This was a cross-sectional online survey study among patients with T2DM in Japan. Patients with T2DM were categorized into one of the three groups: (1) patients on treatment with oral hypoglycemic agent(s) only, (2) patients on combination treatment with oral hypoglycemic agent(s) and insulin, and (3) patients diagnosed with or suspected to have T2DM with no current or past experience with T2DM drug treatment (treatment naïve). Preliminary logistic regressions and classification and regression tree analysis (QW/QD dosing preferences as the dependent variable) were conducted to identify key predictors of dosing preference, followed by an evaluation of frequencies and trends in dosing preferences by the identified factors (subgroups). Current treatment regimen, age, and work status were identified as the major demographic factors that were most predictive of QW preference. While, overall, 55.5% preferred QD and 33.3% preferred QW, the preference toward QW is higher in a specific cohort of patients that is treatment naïve (i.e., patients diagnosed with T2DM and/on diet/exercise therapy with no current or past experience with T2DM drug treatment) than who are on treatment, younger (age ≤64 years old), working full-time than part-time, and/or currently taking 0 or 1 drugs or more than 6 drugs (68.67% versus 30.12%). The most commonly cited reasons for QW preference were (1) "less burdensome because they didn't have to take it every day" (47.8%), (2) "less psychological burden" (14.6%), and (3) "forget to take it less often"(12.5%). Patients with T2DM vary in terms of preference for dosing regimens. Daily dosing was preferred over QW dosing in the overall population, however, preference for QW was higher in younger, full-time working, treatment naïve subjects, who are/or currently taking 0 or 1 drugs or more than 6 drugs.
在2型糖尿病(T2DM)患者中,影响其坚持现有治疗方案的因素众多,其中给药方案的复杂性是一个重要因素。此外,与每日一次、两次或三次(QD、BID、TID)给药方案相比,T2DM口服药物每周一次(QW)给药的价值尚不清楚。本研究旨在通过基于调查的方法,确定与每日给药相比更倾向于QW给药的亚组和患者特征。这是一项针对日本T2DM患者的横断面在线调查研究。T2DM患者被分为三组之一:(1)仅接受口服降糖药治疗的患者;(2)接受口服降糖药和胰岛素联合治疗的患者;(3)诊断为或疑似患有T2DM但目前或过去没有T2DM药物治疗经验(初治)的患者。进行初步逻辑回归以及分类和回归树分析(以QW/QD给药偏好作为因变量),以确定给药偏好的关键预测因素,随后评估所确定因素(亚组)的给药偏好频率和趋势。目前的治疗方案、年龄和工作状态被确定为最能预测QW偏好的主要人口统计学因素。总体而言,55.5%的患者更喜欢QD给药,33.3%的患者更喜欢QW给药,然而,在特定的初治患者队列(即诊断为T2DM且仅接受饮食/运动治疗、目前或过去没有T2DM药物治疗经验的患者)中,对QW的偏好高于正在接受治疗的患者,年龄较小(年龄≤64岁)、全职工作而非兼职工作的患者,和/或目前服用0种或1种药物或超过6种药物的患者(68.67%对30.12%)。最常被提及的偏好QW给药的原因是:(1)“不必每天服药,负担较轻”(47.8%);(2)“心理负担较小”(14.6%);(3)“更少忘记服药”(12.5%)。T2DM患者在给药方案偏好方面存在差异。总体人群中更喜欢每日给药而非QW给药,然而,在年龄较小、全职工作、初治的受试者中,以及正在服用或目前服用0种或1种药物或超过6种药物的患者中,对QW的偏好更高。