Understanding Reasons for Treatment Discontinuation, Attitudes and Education Needs Among People Who Discontinue Type 2 Diabetes Treatment: Results from an Online Patient Survey in the USA and UK
Understanding Reasons for Treatment Discontinuation, Attitudes and Education Needs Among People Who Discontinue Type 2 Diabetes Treatment: Results from an Online Patient Survey in the USA and UK
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DOI：
10.1007/s13300-020-00843-9
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发表时间：
2020-06-12
期刊：
影响因子：
3.8
通讯作者：
Shaunik, Alka
中科院分区：
文献类型：
--
作者：
de Climens, Aude Roborel;Pain, Emilie;Shaunik, Alka
引言2型糖尿病（T2 DM）需要长期治疗以实现和维持血糖控制;然而，高达50%的T2 DM患者在1年内停止治疗。因此，重要的是要了解患者的治疗依从性和持久性的观点。方法通过在线患者社区Carenity的平台PatientLive（R）向美国和英国的T2 DM患者提供在线问卷调查。那些在过去6个月内停止至少一种T2 DM治疗的人回答了开放式问题，旨在评估停止治疗的原因、如何预防停止治疗以及如何改善停止治疗的体验。对答复者对这些问题的回答进行了专题定性分析。结果口服降糖药是最常见的停用药物（93/161），其次是胰岛素（40/161）和胰高血糖素样肽1受体激动剂（13/161）。总体而言，治疗中止的主要原因是副作用（57/161），主要是胃肠道副作用和体重增加。报告的第二大原因是药物疗效问题（42/161）。防止停药的关键因素是改善的护理途径（45/161）和更有效的治疗，副作用更少（41/161）。在美国，治疗费用在停药（14/89）和预防停药（12/89）中起重要作用。更多关于T2 DM和相关治疗的信息（56/161），帮助T2 DM管理（24/161），以及增加和提供信息的患者-医生互动（12/161）将有助于这两个国家的许多受访者，而一些患者指出，没有额外的信息有助于改善他们对T2 DM治疗的理解和经验（64/161）.结论：这些结果强调需要有针对性的医学教育和改善沟通，以提高患者的经验，防止治疗中断。了解T2 DM患者偏好的属性有助于改善当前药物的治疗依从性和结局，并指导未来疗法的开发。
Introduction Type 2 diabetes mellitus (T2DM) requires long-term treatment to achieve and maintain glycaemic control; however, up to 50% of people with T2DM discontinue treatment by 1 year. It is therefore important to understand the patient perspective of therapeutic adherence and persistence. Methods An online questionnaire was presented to people with T2DM in the USA and UK on PatientLive(R), a platform of Carenity, an online patient community. Those who discontinued at least one T2DM treatment within the last 6 months answered open-ended questions aimed to assess the reasons for discontinuation, how discontinuation could have been prevented, and what would have improved the experience with the discontinued treatment. Thematic qualitative analysis was performed on respondents' answers to these questions. Results Oral antidiabetics were the most commonly discontinued treatments (93/161), followed by insulin (40/161) and glucagon-like peptide 1 receptor agonists (13/161). Main reasons for treatment discontinuation overall were side effects (57/161), mostly gastrointestinal side effects and weight gain. The second most reported reason was drug efficacy issues (42/161). Key factors stated to prevent discontinuation were an improved care pathway (45/161) and more efficacious treatments with fewer side effects (41/161). In the USA, treatment cost played an important role in discontinuation (14/89) and discontinuation prevention (12/89). More information about T2DM and associated treatments (56/161), help with T2DM management (24/161), and increased and informative patient-physician interaction (12/161) would have been helpful for many respondents in both countries, while some patients noted that no additional information would have been useful to improve their understanding and experience with their T2DM treatment (64/161). Conclusions These results emphasise the need for focused medical education and improved communication to enhance patient experience and prevent treatment discontinuation. Understanding of attributes preferred by people with T2DM can help improve therapeutic adherence and outcomes with current medications, and guide development of future therapies.