Chen Yingjie, Ren Zonghao, Zhou Xiujuan, Gao Peiyang
School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China.
Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China.
Patient Prefer Adherence. 2025 Sep 19;19:2949-2957. doi: 10.2147/PPA.S540261. eCollection 2025.
To systematically synthesize evidence on treatment preferences, values, and expectations among patients with Graves' disease (GD), in order to understand the disease's impact on quality of life and inform clinical decision-making..
PubMed, Embase, Web of Science, and Cochrane Library were searched for articles about GD, patient preferences, and expectations from database inception to December 2024. Studies included in the review must report raw data on patient-reported outcomes, preferences or experiences relating to GD, and must undergo quality assessment according to the Agency for Healthcare Research and Quality (AHRQ).
Twenty-one studies involving patients with GD were included. Although preferences varied, several trends emerged: 1) Most patients reported that GD significantly disrupted their quality of life and social functioning, with 60% experiencing severe discomfort. 2) Antithyroid drugs (ATD) was the most preferred initial treatment (64%), followed by surgery (25%) and radioactive iodine therapy (RAI) (11%), with concerns about radioactivity and surgical complications influencing decisions. 3) Key factors affecting treatment choices included remission rates, recovery time, impact on daily life, and physician recommendations. 4) Graves' ophthalmopathy (GO) patients faced additional challenges, including social withdrawal and appearance-related distress, with female patients expressing greater concern about disfigurement.
This systematic review indicates that GD, particularly GO, significantly impairs patients' self-confidence, quality of life, and social functioning. Treatment choices are influenced by expected outcomes, personal circumstances, psychological concerns, and economic factors. ATD remains the preferred first-line treatment, though individual preferences vary significantly, emphasizing the importance of personalized approaches and decision aids.
系统地综合格雷夫斯病（GD）患者的治疗偏好、价值观和期望方面的证据，以了解该疾病对生活质量的影响并为临床决策提供依据。
检索了PubMed、Embase、Web of Science和Cochrane图书馆中从数据库建立至2024年12月关于GD、患者偏好和期望的文章。纳入综述的研究必须报告患者报告结局的原始数据、与GD相关的偏好或经历，并且必须根据医疗保健研究与质量机构（AHRQ）进行质量评估。
纳入了21项涉及GD患者的研究。尽管偏好各不相同，但出现了几个趋势：1）大多数患者报告称GD严重扰乱了他们的生活质量和社会功能，60%的患者经历了严重不适。2）抗甲状腺药物（ATD）是最首选的初始治疗方法（64%），其次是手术（25%）和放射性碘治疗（RAI）（11%），对放射性和手术并发症的担忧影响了决策。3）影响治疗选择的关键因素包括缓解率、恢复时间、对日常生活的影响以及医生的建议。4）格雷夫斯眼病（GO）患者面临额外的挑战，包括社交退缩和与外貌相关的困扰，女性患者对毁容表达了更大的担忧。
这项系统综述表明，GD，尤其是GO，会显著损害患者的自信心、生活质量和社会功能。治疗选择受到预期结果、个人情况、心理担忧和经济因素的影响。ATD仍然是首选的一线治疗方法，尽管个体偏好差异很大，这强调了个性化方法和决策辅助工具的重要性。
