Acupuncture or Low Frequency Infrared Treatment for Low Back Pain in Chinese Patients: A Discrete Choice Experiment
Acupuncture or Low Frequency Infrared Treatment for Low Back Pain in Chinese Patients: A Discrete Choice Experiment
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DOI：
10.1371/journal.pone.0126912
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发表时间：
2015-05-28
期刊：
影响因子：
3.7
通讯作者：
Knaggs, Roger D.
中科院分区：
文献类型：
--
作者：
Chen, Li-Chia;Cheng, Li-Jen;Knaggs, Roger D.
针灸是一种受欢迎但有争议的治疗腰痛的方法。在中国，它是作为传统的中医药;其他治疗腰痛的策略通常作为西医。关于患者对腰痛治疗方案偏好的研究主要在西方国家进行，并且仅限于愿意支付的方法。2011年9月至2012年8月，在研究环境中的科学研究部门批准后，进行了一项状态偏好，离散选择实验，以确定中国患者对针灸和低频红外治疗腰痛的偏好和权衡。在研究期间，在中国广东省的一家中医院的“传统医学科”和一家西医院的“康复科”就诊的86名慢性腰痛的成年门诊患者参加了一项访谈调查。一份包含10个场景（每个场景中有5个属性）的问卷被用来询问参与者对针灸、低频红外治疗或两者都不选择的偏好。使用nested-logit模型分析经验证的应答。是否接受治疗的决定与接受治疗的预期效用无关，女性和较高的自付费用显著降低了接受治疗的机会。在接受针灸或低频红外线治疗的效用中，治疗感觉是作为治疗效果指标的最重要属性，其次是最大疗效、维持时间和疗效起效以及自付费用。患者对针灸和低频红外线治疗的支付意愿分别为每疗程618.6美元和592.4美元，反映了患者对疼痛管理的需求。治疗感觉被认为是治疗效果的一个指标，也是选择针灸或低频红外治疗的最重要因素。高支付意愿反映了患者对疼痛管理的需求。然而，可能还有其他因素影响患者接受治疗的偏好。
Acupuncture is a popular but controversial treatment option for low back pain. In China, it is practised as traditional Chinese medicine; other treatment strategies for low back pain are commonly practised as Western medicine. Research on patient preference for low backpain treatment options has been mainly conducted in Western countries and is limited to a willingness-to-pay approach. A stated-preference, discrete choice experiment was conducted to determine Chinese patient preferences and trade-offs for acupuncture and low frequency infrared treatment in low back pain from September 2011 to August 2012 after approval from the Department of Scientific Research in the study settings. Eight-six adult outpatients who visited the 'traditional medicine department' at a traditional Chinese medicine hospital and the 'rehabilitation department' at a Western medicine hospital in Guangdong Province of China for chronic low back pain during study period participated in an interview survey. A questionnaire containing 10 scenarios (5 attributes in each scenario) was used to ask participants' preference for acupuncture, low frequency infrared treatment or neither option. Validated responses were analysed using a nested-logit model. The decision on whether to receive a therapy was not associated with the expected utility of receiving therapy, female gender and higher out-of-pocket payment significantly decreased chance to receive treatments. Of the utility of receiving either acupuncture or low frequency infrared treatment, the treatment sensation was the most important attribute as an indicator of treatment efficacy, followed by the maximum efficacy, maintenance duration and onset of efficacy, and the out-of-pocket payment. The willingness-to-pay for acupuncture and low frequency infrared treatment were about $618.6 and $592.4 USD per course respectively, demonstrated patients' demand of pain management. The treatment sensation was regarded as an indicator of treatment efficacy and the most important attribute for choosing acupuncture or low frequency infrared treatment. The high willingness-to-pay demonstrated patients' demand of pain management. However, there may be other factors influencing patients' preference to receive treatments.