A Survey of Patient Preferences for Oral Antihyperglycemic Therapy in Patients with Type 2 Diabetes Mellitus
A Survey of Patient Preferences for Oral Antihyperglycemic Therapy in Patients with Type 2 Diabetes Mellitus
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DOI：
10.1007/s13300-015-0094-2
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发表时间：
2015-03-01
期刊：
影响因子：
3.8
通讯作者：
Radican, Larry
中科院分区：
文献类型：
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作者：
Hauber, A. Brett;Tunceli, Kaan;Radican, Larry
前言：先前的研究已经证明了患者喜好、服药负担和药物不依从性之间的相关性，这是人们公认的2型糖尿病(T2 DM)的挑战。本研究的目的是了解T2 DM患者对口服降糖药物不同给药方案的偏好，并量化不同特征的患者对口服降糖药物(OAD)剂量偏好的差异。方法：通过对美国T2 DM患者的调查，评估对口服降糖药物(OAD)的偏好。调查参与者是成年的美国T2 DM患者，他们没有或只接受了1次OAD和没有注射治疗。每个患者都完成了一项网络支持的离散选择实验(DCE)，包括一系列8对假想的OAD资料。根据平均血糖、给药计划(例如，每周一次、每天一次或每天两次)、轻度至中度胃肠道副作用、低血糖频率、体重变化、充血性心力衰竭的增量风险和费用的减少来定义每个特征。每个参与者还回答了一个关于剂量偏好的直接问题。使用随机参数Logit对DCE数据进行分析。结果：在2262名受邀参与的患者中，923人进入分析(平均年龄63岁，其中45%为男性，79%为白人)。减少给药频率对患者具有统计学意义上的重要性；然而，与药物成本或临床结果相比，它相对没有那么重要。平均而言，患者更喜欢每周一次，而不是每天一次。与正在接受治疗的患者相比，目前没有服用口服避孕药的患者更倾向于每周服用一次(P=0.012)。45岁以下的患者比年龄较大的患者更倾向于每周给药(P<；0.075)。结论：对于更年轻的患者和目前没有接受治疗的患者，每周给药可能会提供额外的激励，促使他们开始并坚持降血糖治疗；然而，还需要更多的研究来证实这一假设。
Introduction: Previous research has demonstrated a correlation among patient preferences, dosing burden, and medication nonadherence, a well-recognized challenge in type 2 diabetes mellitus (T2DM). The objective of this study was to elicit preferences for alternative dosing regimens for oral antihyperglycemic therapies among patients with T2DM and to quantify differences in dosing preferences among patients with different characteristics.Methods: Preferences for dosing of oral antihyperglycemic drugs (OAD) were evaluated by surveying patients with T2DM in the United States (US). Survey participants were adult US patients with T2DM who were taking no or only 1 OAD and no injectable therapies. Each patient completed a web-enabled discrete-choice experiment (DCE) including a series of 8 pairs of hypothetical OAD profiles. Each profile was defined by reductions in average glucose, dosing schedule (e.g., once-weekly, once-daily, or twice-daily dosing), chance of mild-to-moderate gastrointestinal side effects, frequency of hypoglycemia, weight change, incremental risk of congestive heart failure, and cost. Each participant also answered a direct question about dosing preference. Random-parameters logit was used to analyze the DCE data. Prespecified subgroups were analyzed.Results: Of 2,262 patients invited to participate, 923 were included in the analysis (mean age 63 years, 45% male, 79% white). Reducing dosing frequency was statistically significantly important to patients; however, it was relatively less important than medication cost or clinical outcomes. On average, patients preferred once-weekly to once-daily dosing. Patients not currently taking an OAD had a stronger preference for once-weekly dosing than patients on treatment (P = 0.012). Patients younger than 45 years had a stronger preference for weekly dosing than older patients (P < 0.075).Conclusions: For younger patients and patients not currently on treatment, once-weekly dosing may provide additional incentive to initiate and adhere to antihyperglycemic treatment; however, additional research will be required to confirm this hypothesis.