Patient Preferences for Noninsulin Diabetes Medications: A Systematic Review
Patient Preferences for Noninsulin Diabetes Medications: A Systematic Review
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DOI：
10.2337/dc13-2527
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发表时间：
2014-07-01
期刊：
影响因子：
16.2
通讯作者：
Maruthur, Nisa
中科院分区：
文献类型：
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作者：
Purnell, Tanjala S.;Joy, Susan;Maruthur, Nisa
需要对患者高血糖管理的偏好进行循证综合。我们的目的是系统地审查患者的偏好非胰岛素糖尿病药物治疗成人2型diabetes.RESEARCH设计和METHODSWe检索PubMed，Embase，CINAHL和EconLit数据库发表的文章或之前2013年1月23日。我们纳入了2型糖尿病成人患者的英语研究，评估了患者对糖尿病药物治疗的偏好。标题、摘要和文章由至少两名独立评审员进行评审。研究数据和质量采用标准方案进行提取。在我们最初检索的2，811篇文章中，10篇符合系统评价的纳入标准。研究于2007年至2012年在美国不同的患者人群中进行。美国，瑞典、丹麦和美国。K.用于评估患者偏好的方法包括离散选择实验（e.例如，在一个实施例中，联合分析）、时间权衡练习、标准赌博和患者调查。与患者偏好相关的糖尿病药物的关键属性包括治疗益处（e.例如，在一个实施例中，血糖控制和体重减轻/控制）、治疗负担（e.例如，在一个实施例中，给药、频率和成本）和副作用（e.例如，在一个实施例中，体重增加、胃肠道效应和低血糖）。结论各种临床和生活质量相关因素影响患者对非胰岛素糖尿病药物的偏好。据报告，血糖控制和体重减轻/控制方面的治疗疗效以及治疗相关低血糖和胃肠道效应的风险是患者治疗选择的重要驱动因素。未来的工作需要确定将患者的喜好纳入治疗决策和以患者为中心的护理的实用方法。
OBJECTIVEAn evidence-based synthesis of patient preferences for management of hyperglycemia is needed. Our objective was to systematically review patient preferences for noninsulin diabetes medications in adults with type 2 diabetes.RESEARCH DESIGN AND METHODSWe searched the PubMed, Embase, CINAHL, and EconLit databases for articles published on or before 23 January 2013. We included English-language studies of adult patients with type 2 diabetes that assessed patient preferences for diabetes medication treatment. Titles, abstracts, and articles were reviewed by at least two independent reviewers. Study data and quality were abstracted with standard protocols.RESULTSOf 2,811 titles identified in our original search, 10 articles met inclusion criteria for the systematic review. Studies were conducted from 2007 to 2012 among diverse patient populations in the U. S., Sweden, Denmark, and the U. K. Methods used to assess patient preferences included discrete choice experiments (e. g., conjoint analysis), time tradeoff exercises, standard gamble, and patient surveys. Key attributes of diabetes medication associated with patient preferences included treatment benefits (e. g., glycemic control and weight loss/control), treatment burden (e. g., administration, frequency, and cost), and side effects (e. g., weight gain, gastrointestinal effects, and hypoglycemia).CONCLUSIONSVarious clinical and quality of life-related factors influence patient preferences for noninsulin diabetes medications. Treatment efficacy with regard to glycemic control and weight loss/control and the risk of treatment-related hypoglycemia and gastrointestinal effects are reported to be important drivers of patient treatment selections. Future work is needed to identify practical methods for incorporating patient preferences into treatment decision making and patient-centered care.