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Patient preferences in the treatment of diabetic retinopathy

机译：糖尿病视网膜病变的患者偏爱

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Objective: Accounting for patient preferences may be especially important in diabetes mellitus, given the challenge in identifying factors associated with treatment adherence. Although preference studies have been performed in diabetes, none have examined treatments used in diabetic retinopathy (DR). The objective of this study was to elicit patient preferences for attributes associated with antivascular endothelial growth factor, focal and panretinal laser, and steroid therapy used in DR management.Methods: A cross-sectional conjoint survey was administered to DR patients at three Canadian eye centers. The survey involved making tradeoffs among 11 DR treatment attributes, including the chance of improving vision and risks of adverse events over a 1-year treatment period. Attribute utilities were summed for each product profile to determine the most preferred treatment.Results: Based on the results from 161 patients, attributes affecting visual functioning, including improving visual acuity and reducing adverse events (eg, chance of cataracts), were more important than those not directly affecting vision (eg, administration). Overall, 52%, 20%, 17%, and 11% preferred the product profiles matching to the antivascular endothelial growth factor, steroid, focal laser, and panretinal laser therapies. Preferences did not vary substantially by previous treatment experience, age, or type of DR (macular edema, proliferative DR, both or neither), with the exception that more macular edema only patients preferred focal laser over steroid treatment (19% versus 14%, respectively).Conclusions: When considering the potential effects of treatment over a 1-year period, treatment preferences in DR are most influenced by those that may positively or negatively affect visual functioning.
机译：目的：考虑到识别与治疗依从性相关的挑战，在糖尿病患者中考虑患者的偏好可能尤其重要。尽管已经对糖尿病进行了偏爱研究，但没有人检查过糖尿病性视网膜病（DR）中使用的治疗方法。这项研究的目的是引起患者对与抗血管内皮生长因子，局灶性和全视网膜激光以及类固醇治疗中使用的类固醇治疗相关的属性的偏爱。方法：对三个加拿大眼科中心的DR患者进行横断面联合调查。该调查涉及在11种DR治疗属性之间进行权衡，包括在1年的治疗期内改善视力和不良事件风险的机会。结果：根据161例患者的结果，影响视觉功能的属性（包括改善视敏度和减少不良事件（例如白内障的机会））比161个患者的结果更为重要。不直接影响视力的人（例如行政管理）。总体而言，有52％，20％，17％和11％的人喜欢与抗血管内皮生长因子，类固醇，聚焦激光和全视网膜激光疗法相匹配的产品。根据先前的治疗经验，年龄或DR类型（黄斑水肿，增生性DR，两者或两者都不是），偏好没有实质性变化，只是更多的黄斑水肿患者更喜欢使用聚焦激光而不是类固醇治疗（19％比14％，结论：在考虑一年期治疗的潜在影响时，DR中的治疗偏爱受可能对视觉功能产生正面或负面影响的那些偏见最大。

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