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患者对肩部疼痛保守治疗的偏好:一项离散选择实验

Patient preferences for conservative treatment of shoulder pain: a discrete choice experiment.

作者信息

Versloot Annelotte H C, Veldwijk Jorien, Ottenheijm Ramon P G, de Graaf Marloes, van der Windt Daniëlle A, Koes Bart W, Runhaar Jos, Schiphof Dieuwke

机构信息

Department of General Practice, Erasmus Medical Center, Dr Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.

Erasmus School of Health Policy and Management, Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands.

出版信息

Fam Pract. 2025 Feb 7;42(2). doi: 10.1093/fampra/cmae050.

Abstract

BACKGROUND

Shoulder pain is common amongst adults, but little is known about patients' preferences.

OBJECTIVE

The aim of this study was to determine patients' preferences for treatment options offered for shoulder pain in primary care.

METHODS

A discrete choice experiment was used to investigate these preferences. Adults with shoulder pain were asked to make 12 choices between two treatment options, or to opt-out. The attributes of the 12 treatment options were presented as varying in: treatment effectiveness (50%, 70%, or 90%), risk of relapse (10%, 20%, or 30%), time to pain reduction (2 or 6 weeks), prevention of relapse (yes/no), requiring injection (yes/no), and including physiotherapy (none, 6, or 12 sessions). A conditional logit model with latent class analysis was used for the analysis and a class assignment model.

RESULTS

Three hundred and twelve participants completed the questionnaire with mean age of 52 ± 15.2 years. Latent class analysis revealed three groups. Group 1 preferred to opt-out, unless the attributes were highly favorable (90% effectiveness). Group 2 preferred treatment, but not an injection. Group 3 preferred to opt-out and did not opt for treatment. The likelihood of a participant belonging to one of these groups was 68.8%, 9.3%, and 21.9%, respectively. The class assignment was related to having previously received injection or physiotherapy, as they did not prefer that same treatment again.

CONCLUSION

This study showed that most patients with shoulder pain prefer to opt-out, unless treatment attributes are highly favorable. Characteristics of influence on this decision was whether the patient had received an injection or physiotherapy before.

摘要

背景

肩痛在成年人中很常见,但对于患者的偏好了解甚少。

目的

本研究旨在确定患者对初级保健中提供的肩痛治疗方案的偏好。

方法

采用离散选择实验来调查这些偏好。患有肩痛的成年人被要求在两种治疗方案之间做出12次选择,或者选择退出。12种治疗方案的属性在以下方面有所不同:治疗效果(50%、70%或90%)、复发风险(10%、20%或30%)、疼痛减轻时间(2周或6周)、预防复发(是/否)、是否需要注射(是/否)以及是否包括物理治疗(无、6次或12次)。使用带有潜在类别分析的条件logit模型进行分析以及类别分配模型。

结果

312名参与者完成了问卷,平均年龄为52±15.2岁。潜在类别分析揭示了三组。第1组除非属性非常有利(90%的有效性),否则倾向于选择退出。第2组倾向于接受治疗,但不接受注射。第3组倾向于选择退出且不选择治疗。参与者属于这些组之一的可能性分别为68.8%、9.3%和21.9%。类别分配与之前是否接受过注射或物理治疗有关,因为他们不想再次接受相同的治疗。

结论

本研究表明,大多数肩痛患者倾向于选择退出,除非治疗属性非常有利。影响这一决定的特征是患者之前是否接受过注射或物理治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79b6/11878378/0a86536a3f56/cmae050_fig1.jpg

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