Preferences for Outcomes Among Adults with Type 1 Diabetes and Caregivers of Children with Type 1 Diabetes.
Preferences for Outcomes Among Adults with Type 1 Diabetes and Caregivers of Children with Type 1 Diabetes.
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DOI：
10.2147/ppa.s262358
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发表时间：
2020
影响因子：
2.2
通讯作者：
Mansfield C
中科院分区：
文献类型：
--
作者：
Marinac M;Sutphin J;Hutton C;Klein K;Sullivan S;Mansfield C
血红蛋白A1c（HbA1c）是1型糖尿病治疗有效性的公认指标。我们调查了1型糖尿病成人和1型糖尿病儿童的照顾者对除HbA1c外的糖尿病控制措施的偏好。使用离散选择实验方法，对1型糖尿病成年患者和护理人员进行的调查提供了由六个不同水平的属性描述的假设治疗之间的选择：HbA1c，最佳血糖范围内的时间，每周低血糖和高血糖事件的数量和严重程度，额外的疾病管理时间和额外的治疗费用。使用随机参数logit分析选择数据。共有300名1型糖尿病患者和400名护理人员完成了调查。成人和护理人员最重视减少低血糖和高血糖事件。对于成年人，每周避免1 - 5次轻度至中度低血糖事件（血糖54 - 69 mg/dL）比HbA1c目标值高出半个点重要5倍。每周避免1 - 5次高血糖事件（葡萄糖> 180 mg/dL）比目标HbA1c高半个点重要7倍。在最佳葡萄糖范围内的额外时间与HbA1c降低大于半个点同样重要。避免高血糖和低血糖事件比所有其他结果更重要的幼儿照顾者。> 12岁儿童的照顾者比年幼儿童的照顾者相对更重视避免低血糖事件<54 mg/dL，并且更喜欢避免额外费用。1型糖尿病成人患者和护理人员应优先控制低血糖和高血糖事件，包括轻度至中度事件。在药物开发和监管决策中应考虑这些偏好。将您的智能手机指向上面的代码。如果你有一个QR码阅读器，视频摘要将出现。或用途：www.example.com
Hemoglobin A1c (HbA1c) is the accepted measure of effectiveness for type 1 diabetes therapies. We investigated preferences for measures of diabetes control in addition to HbA1c among adults with type 1 diabetes and caregivers of children with type 1 diabetes. Using discrete-choice experiment methodology, surveys for adults with type 1 diabetes and caregivers presented choices between hypothetical treatments described by six attributes with varying levels: HbA1c, time in optimal glucose range, weekly number and severity of hypoglycemic and hyperglycemic events, additional disease management time, and additional treatment cost. Choice data were analyzed using random-parameters logit. A total of 300 adults with type 1 diabetes and 400 caregivers completed the survey. Adults and caregivers placed the most importance on reducing hypoglycemic and hyperglycemic events. For adults, avoiding 1–5 mild-to-moderate hypoglycemic events (glucose 54–69 mg/dL)/week was five times more important than being a half-point above target HbA1c. Avoiding 1–5 hyperglycemic events (glucose >180 mg/dL)/week was seven times more important than being a half-point above target HbA1c. Additional time in optimal glucose range was as important as a reduction greater than a half-point in HbA1c. Avoiding hyperglycemic and hypoglycemic events was more important than all other outcomes for caregivers of younger children. Caregivers of children >12 years placed relatively more weight on avoiding hypoglycemic events <54 mg/dL than those with younger children and preferred avoiding additional costs. Adults with type 1 diabetes and caregivers prioritize controlling hypoglycemic and hyperglycemic events, including mild-to-moderate events. These preferences should be considered in drug development and regulatory decisions. Point your SmartPhone at the code above. If you have a QR code reader, the video abstract will appear. Or use: https://youtu.be/zPrBA6mK5hM