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Education and patient preferences for treating type 2 diabetes: a stratified discrete-choice experiment

机译：教育和患者对2型糖尿病的偏爱：分层离散选择实验

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Purpose: Diabetes is a chronic condition that is more prevalent among people with lower educational attainment. This study assessed the treatment preferences of patients with type 2 diabetes by educational attainment. Methods: Patients with type 2 diabetes were recruited from a national online panel in the US. Treatment preferences were assessed using a discrete-choice experiment. Participants completed 16 choice tasks in which they compared pairs of treatment profiles composed of six attributes: A1c decrease, stable blood glucose, low blood glucose, nausea, treatment burden, and out-of-pocket cost. Choice models and willingness-to-pay (WTP) estimates were estimated using a conditional logit model and were stratified by educational status. Results: A total of 231 participants with a high school diploma or less education, 156 participants with some college education, and 165 participants with a college degree or more completed the survey. Participants with a college degree or more education were willing to pay more for A1c decreases ($58.84, standard error [SE]: 10.6) than participants who had completed some college ($28.47, SE: 5.53) or high school or less ($17.56, SE: 3.55) ( p ≤0.01). People with a college education were willing to pay more than people with high school or less to avoid nausea, low blood glucose events during the dayight, or two pills per day. Conclusion: WTP for aspects of diabetes medication differed for people with a college education or more and a high school education or less. Advanced statistical methods might overcome limitations of stratification and advance understanding of preference heterogeneity for use in patient-centered benefit–risk assessments and personalized care approaches.
机译：目的：糖尿病是一种慢性病，在教育程度较低的人群中更为普遍。这项研究通过教育程度评估了2型糖尿病患者的治疗偏好。方法：2型糖尿病患者是从美国的一个全国性在线小组中招募的。使用离散选择实验评估治疗偏好。参与者完成了16个选择任务，他们比较了由6个属性组成的成对治疗方案：A1c降低，血糖稳定，低血糖，恶心，治疗负担和自付费用。选择模型和支付意愿（WTP）估计值是使用条件logit模型估计的，并按受教育程度进行分层。结果：共有231名具有高中文凭或以下文化程度的参与者，156名具有一定大学学历的参与者和165名具有大专以上学历的参与者完成了调查。具有大学学历或更高学历的参与者愿意为A1c降低（58.84美元，标准误[SE]：10.6）付出比完成某些大学（28.47美元，SE：5.53）或高中或以下（17.56美元，SE）的更高的费用。 ：3.55）（p≤0.01）。受过大学教育的人愿意支付的费用比高中或以下的人要多，以避免恶心，白天/晚上出现低血糖事件或每天两丸。结论：糖尿病药物治疗方面的WTP对于受过大学或以上学历且具有高中或以下学历的人有所不同。先进的统计方法可能会克服分层的局限性，并进一步了解偏爱异质性，以用于以患者为中心的利益风险评估和个性化护理方法。

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