Dai Jing, He Ting, He Xiaodie, Li Huaying, Li Lintong, Sun Jie, Pan Jie, Ji Cheng
Department of Pharmacy The Second Affiliated Hospital of Soochow University, Suzhou, China.
Department of Pharmacy China Pharmaceutical University Nanjing Drum Tower Hospital, Nanjing, China.
J Diabetes Res. 2024 Sep 6;2024:2552658. doi: 10.1155/2024/2552658. eCollection 2024.
Effective glycemic control is crucial for hospitalized patients, leading to benefits such as shorter hospital stays and reduced postoperative infection rates. While previous studies have emphasized the effectiveness of multidisciplinary collaborative stewardship for hospital-wide hyperglycemia management, patient perspectives and preferences have not been adequately considered. To identify factors influencing treatment preferences of Chinese hospitalized diabetes patients using discrete choice experiments (DCEs) and provide practical insights for the construction of a hospital-wide glycemic control programme. A face-to-face survey was conducted among diabetes patients admitted to nonendocrine departments in a tertiary hospital in Nanjing, China. The attributes and levels were determined based on DCE principles, and a conditional logit model was used to quantify patients' preferences. A total of 157 respondents were analyzed. Antihyperglycemic effectiveness, healthcare providers, treatment regimen, monitoring frequency, and adverse reactions were the five attributes that significantly influenced patient preference ( < 0.05). Notably, an 80% glycemic control rate ( = 2.009) and a multidisciplinary management team involving clinical pharmacists ( = 1.346) had the greatest impact. Negative effects were observed for hypoglycemia ( = -1.008), insulin pump use ( = -0.746), and frequent glucose monitoring ( = -0.523). Female patients exhibited higher concern for healthcare providers ( = 1.172) compared to males. Younger and shorter-course patients prioritized antihyperglycemic effectiveness ( = 3.330, = 1.510), while older patients preferred multidisciplinary management ( = 1.186) and opposed increased monitoring frequency ( = -0.703). Patients with higher educational backgrounds showed greater acceptance of continuous glucose monitoring ( = 1.983), and those with higher annual income placed more emphasis on glycemic control rate. Treatment preferences of hospitalized diabetes patients are mainly influenced by antihyperglycemic effectiveness, adverse reactions, healthcare providers, and individual characteristics. Comprehensive consideration and an individualized therapy strategy should be given when constructing a hospital-wide glycemic control programme.
有效的血糖控制对住院患者至关重要，可带来缩短住院时间和降低术后感染率等益处。虽然先前的研究强调了多学科协作管理对全院高血糖管理的有效性，但患者的观点和偏好尚未得到充分考虑。本研究旨在通过离散选择实验（DCE）确定影响中国住院糖尿病患者治疗偏好的因素，并为构建全院血糖控制方案提供实践见解。在中国南京一家三级医院的非内分泌科室住院的糖尿病患者中进行了面对面调查。根据DCE原则确定属性和水平，并使用条件logit模型量化患者的偏好。共分析了157名受访者。降糖效果、医护人员、治疗方案、监测频率和不良反应是显著影响患者偏好的五个属性（<0.05）。值得注意的是，80%的血糖控制率（=2.009）和包括临床药师的多学科管理团队（=1.346）影响最大。低血糖（=-1.008）、胰岛素泵使用（=-0.746）和频繁血糖监测（=-0.523）产生负面影响。与男性相比，女性患者对医护人员更为关注（=1.172）。病程较短的年轻患者优先考虑降糖效果（=3.330，=1.510），而老年患者则倾向于多学科管理（=1.186），并反对增加监测频率（=-0.703）。受教育程度较高的患者对持续血糖监测的接受度更高（=1.983），年收入较高的患者更注重血糖控制率。住院糖尿病患者的治疗偏好主要受降糖效果、不良反应、医护人员和个体特征的影响。在构建全院血糖控制方案时应综合考虑并制定个体化治疗策略。
