What do Australian patients with inflammatory arthritis value in treatment? A discrete choice experiment
What do Australian patients with inflammatory arthritis value in treatment? A discrete choice experiment
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DOI：
10.1007/s10067-019-04843-4
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发表时间：
2020-04-01
影响因子：
3.4
通讯作者：
Fifer, Simon
中科院分区：
文献类型：
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作者：
Ho, Kerrie-Anne;Acar, Mustafa;Fifer, Simon
背景和目的本研究的目的是了解炎症性关节炎（IA）[类风湿关节炎（RA），强直性脊柱炎（AS）和银屑病关节炎（PsA）]患者的治疗偏好，重点关注患者价值的治疗属性，其相对重要性，以及患者在治疗选择方面的风险-收益权衡。方法采用离散选择实验（DCE）方法。感兴趣的属性为临床疗效；减缓疾病进展；轻度至中度副作用风险；有严重副作用的风险；给药频率；真实产品证据；相关条件的管理；病人支持项目的可用性。使用来自DCE成分的数据，估计了一个限制潜在类别模型（LCM），以确定治疗偏好的离散“类别”。结果本研究共纳入206例受试者（AS n = 59, PsA n = 62, RA n = 85）。确定了两类。对于“1类”（59.9%），最重要的属性（在所有治疗方式中）是预防疾病进展、临床疗效和轻度至中度副作用的风险。对于“2类”（40.1%），临床和非临床属性是重要的，属性的重要性取决于治疗方式。患者人口统计学和治疗特征不能预测班级成员。结论对大多数IA患者而言，临床疗效、停止疾病进展和轻中度副作用风险是重要的治疗属性。既往有生物DMARD经历的患者更倾向于注射治疗。对于一部分患者，患者支持方案和给药频率是重要的。临床医生在给IA患者开处方时应注意其偏好。
Background and objectives The purpose of this study was to develop an understanding of treatment preferences in patients with inflammatory arthritis (IA) [rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA)] focussing on treatment attributes that patients' value, their relative importance, and the risk-benefit trade-offs that characterise patients' choices around treatment. Methods A discrete choice experiment (DCE) approach was used. Attributes of interest were clinical efficacy; slowing of disease progression; risk of mild-moderate side effects; risk of severe side effects; frequency of administration; real-world product evidence; management of related conditions; and availability of a patient support programme. Using data from the DCE component, a restricted latent class model (LCM) was estimated to determine discrete 'classes' of treatment preferences. Results In this analysis, 206 participants were included (AS n = 59; PsA n = 62; RA n = 85). Two classes were identified. For 'class 1' (59.9%), the most important attributes (across all treatment modalities) were preventing disease progression, clinical efficacy and risk of mild-to-moderate side effects. For 'class 2' (40.1%), clinical and non-clinical attributes were important, and attribute importance depended on treatment modality. Patient demographic and treatment characteristics did not predict class membership. Conclusion For most patients with IA, clinical efficacy, stopping disease progression and risks of mild-to-moderate side effects are important treatment attributes. Patients with prior biologic DMARD experience had greater preference for injection treatments. For a subset of patients, patient support programmes and the frequency of administration were important. Clinicians should be mindful of preferences when prescribing treatment to patients with IA.