Treatment preferences and medication adherence of people with Type 2 diabetes using oral glucose-lowering agents
Treatment preferences and medication adherence of people with Type 2 diabetes using oral glucose-lowering agents
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DOI：
10.1111/j.1464-5491.2009.02696.x
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发表时间：
2009-04-01
影响因子：
3.5
通讯作者：
Falvey, H.
中科院分区：
文献类型：
--
作者：
Hauber, A. B.;Mohamed, A. F.;Falvey, H.
不坚持服药在 2 型糖尿病患者中尤为常见。我们构建了一项离散选择实验，以检验口服降糖药物特征的相对重要性，并估计有效性和副作用对英国和美国 2 型糖尿病患者服药依从性的可能影响。使用横断面、网络调查得出偏好。通过现有的在线慢性病小组招募了自我报告的医生诊断为 2 型糖尿病、目前正在服用口服降糖药物的患者。在每个离散选择问题中，患者被要求在两种假设的药物替代方案中进行选择，每种药物替代方案的定义是糖化血红蛋白的改善、轻度至中度低血糖的频率、水潴留、体重增加、轻度胃部不适和药物相关的心血管风险。患者还被要求指出他们错过或跳过每种假设药物剂量的可能性有多大。英国的 204 名患者和美国的 203 名患者完成了这项调查。两国的偏好没有差异。总体而言，血糖控制是最重要的药物特征，其次是药物相关的心血管风险和体重增加。水潴留对患者来说并不重要。体重增加和心血管风险对可能的药物依从性有显着的负面影响。虽然 2 型糖尿病患者认为血糖控制很重要，但药物副作用和风险会影响患者的治疗选择。药物相关的体重增加和心血管风险是可能不依从药物治疗的重要预测因素。
Medication non-adherence is particularly common in patients with Type 2 diabetes. We constructed a discrete-choice experiment to examine the relative importance of oral glucose-lowering medication features and to estimate the likely effect of effectiveness and side effects on medication adherence in patients with Type 2 diabetes in the UK and the USA.Preferences were elicited using a cross-sectional, web-enabled survey. Patients with a self-reported physician-made diagnosis of Type 2 diabetes, who were currently taking oral glucose-lowering medications were recruited through an existing online chronic-disease panel. In each discrete-choice question, patients were asked to choose between two hypothetical medication alternatives, each defined by improvement in glycated haemoglobin, frequency of mild-to-moderate hypoglycaemia, water retention, weight gain, mild stomach upset and medication-related cardiovascular risk. Patients were also asked to indicate how likely they would be to miss or skip doses of each hypothetical medication.Two hundred and four patients in the UK and 203 patients in the USA completed the survey. Preferences did not differ between the two countries. Overall, glucose control was the most important medication feature, followed by medication-related cardiovascular risk and weight gain, respectively. Water retention was not important to patients. Weight gain and cardiovascular risk had significant negative effects on likely medication adherence.While patients with Type 2 diabetes believe glucose control is important, medication side effects and risks influence patients' treatment choices. Medication-related weight gain and cardiovascular risk are significant predictors of likely medication non-adherence.