Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
Department of Endocrinology, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India.
Patient. 2024 Nov;17(6):619-634. doi: 10.1007/s40271-024-00714-6. Epub 2024 Sep 13.
Poor adherence to anti-osteoporosis treatment is a well-recognized problem, partly due to misalignment with patient preferences. In recent years, several quantitative preference studies have been conducted. This study aimed to systematically review stated preference research to provide a comprehensive overview of patient preferences in osteoporosis, in particular on conditional relative attribute importance and preference heterogeneity.
This systematic review was conducted in MEDLINE and Embase up to February 29th, 2024. It includes all English-language, peer-reviewed, stated preference articles related to osteoporosis management and treatment in patients with or at risk of osteoporosis. Conditional relative importance of attributes as well as heterogeneity was assessed, and attributes classified into outcome, process, and cost attributes. Quality assessment was performed using a combined checklist of Purpose, Respondents, Explanation, Findings, and Significance (PREFS) and International Society for Pharmacoeconomics and Outcomes Research (ISPOR) items.
Fourteen studies including 4714 participants were evaluated. Attributes were mostly classified as process related (50%) and outcome related (40%), both of which significantly influence patient preferences. In pairwise attribute comparison, efficacy was dominant over cost, administration, and side-effects. Preference heterogeneity was observed in the majority of studies (86%). Quality assessment indicated an overall improvement in study quality over time, with recent studies adhering more closely to established methodological standards.
The findings highlight the importance of considering patient preferences in the management of osteoporosis, underscoring the need for a patient-centered approach. The readiness of patients to engage in trade-offs between attributes suggests that healthcare providers should ensure treatments are aligned with individual patient preferences to improve adherence and optimize outcomes.
抗骨质疏松治疗的依从性差是一个众所周知的问题，部分原因是与患者偏好不匹配。近年来，已经进行了几项定量偏好研究。本研究旨在系统地回顾偏好研究，以全面了解骨质疏松症患者的偏好，特别是关于条件相对属性重要性和偏好异质性。
本系统评价在 MEDLINE 和 Embase 中进行，截至 2024 年 2 月 29 日。它包括所有与骨质疏松症管理和治疗相关的、以英语发表的、同行评议的偏好研究，涉及骨质疏松症患者或有骨质疏松症风险的患者。评估了属性的条件相对重要性和异质性，并将属性分类为结局、过程和成本属性。使用目的、受访者、解释、发现和意义（PREFS）和国际药物经济学和结果研究学会（ISPOR）项目的综合检查表对质量进行评估。
评估了 14 项研究，共纳入 4714 名参与者。属性主要分为与过程相关（50%）和与结果相关（40%），两者都显著影响患者的偏好。在成对属性比较中，疗效优于成本、给药和副作用。大多数研究观察到偏好异质性（86%）。质量评估表明，随着时间的推移，研究质量总体上有所提高，最近的研究更符合既定的方法学标准。
研究结果强调了在骨质疏松症管理中考虑患者偏好的重要性，强调了以患者为中心的方法的必要性。患者愿意在属性之间进行权衡，这表明医疗保健提供者应确保治疗与个体患者的偏好相匹配，以提高依从性并优化结果。
