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首页> 外文期刊>Patient Preference and Adherence >Patients’ and physicians’ preferences for type 2 diabetes mellitus treatments in Spain and Portugal: a?discrete choice experiment
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Patients’ and physicians’ preferences for type 2 diabetes mellitus treatments in Spain and Portugal: a?discrete choice experiment

机译：西班牙和葡萄牙的患者和医师对2型糖尿病治疗的偏爱：一项离散选择实验

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Objective: To assess Spanish and Portuguese patients’ and physicians’ preferences regarding type 2 diabetes mellitus (T2DM) treatments and the monthly willingness to pay (WTP) to gain benefits or avoid side effects.Methods: An observational, multicenter, exploratory study focused on routine clinical practice in Spain and Portugal. Physicians were recruited from multiple hospitals and outpatient clinics, while patients were recruited from eleven centers operating in the public health care system in different autonomous communities in Spain and Portugal. Preferences were measured via a discrete choice experiment by rating multiple T2DM medication attributes. Data were analyzed using the conditional logit model.Results: Three-hundred and thirty (n=330) patients (49.7% female; mean age 62.4 [SD: 10.3] years, mean T2DM duration 13.9 [8.2] years, mean body mass index 32.5 [6.8] kg/m2, 41.8% received oral?+ injected medication, 40.3% received oral, and 17.6% injected treatments) and 221 physicians from Spain and Portugal (62% female; mean age 41.9 [SD: 10.5] years, 33.5% endocrinologists, 66.5% primary-care doctors) participated. Patients valued avoiding a gain in bodyweight of 3 kg/6 months (WTP: €68.14 [95% confidence interval: 54.55–85.08]) the most, followed by avoiding one hypoglycemic event/month (WTP: €54.80 [23.29–82.26]). Physicians valued avoiding one hypoglycemia/week (WTP: €287.18 [95% confidence interval: 160.31–1,387.21]) the most, followed by avoiding a 3 kg/6 months gain in bodyweight and decreasing cardiovascular risk (WTP: €166.87 [88.63–843.09] and €154.30 [98.13–434.19], respectively). Physicians and patients were willing to pay €125.92 (73.30–622.75) and €24.28 (18.41–30.31), respectively, to avoid a 1% increase in glycated hemoglobin, and €143.30 (73.39–543.62) and €42.74 (23.89–61.77) to avoid nausea.Conclusion: Both patients and physicians in Spain and Portugal are willing to pay for the health benefits associated with improved diabetes treatment, the most important being to avoid hypoglycemia and gaining weight. Decreased cardiovascular risk and weight reduction became the third most valued attributes for physicians and patients, respectively.
机译：目的：评估西班牙和葡萄牙患者和医生对2型糖尿病（T2DM）治疗的偏好以及每月获得收益或避免副作用的支付意愿（WTP）。方法：一项观察性，多中心，探索性研究，重点是西班牙和葡萄牙的常规临床实践。医师是从多家医院和门诊诊所招募的，而患者则是从西班牙和葡萄牙不同自治区的公共卫生保健系统的十一个中心招募的。通过对多个T2DM药物属性进行评级的离散选择实验来衡量偏好。结果：303例患者（n = 330）（女性49.7％;平均年龄62.4 [SD：10.3]岁，平均T2DM持续时间13.9 [8.2]岁，平均体重指数） 32.5 [6.8] kg / m2，41.8％接受口服+药物治疗，40.3％接受口服治疗，和17.6％注射治疗）以及来自西班牙和葡萄牙的221位医生（女性62％;平均年龄41.9 [SD：10.5]岁， 33.5％的内分泌学家，66.5％的初级保健医生参加了会议。患者最重视避免体重增加3公斤/ 6个月（WTP：68.14欧元[95％置信区间：54.55–85.08]），其次是避免每月一次低血糖事件（WTP：54.80欧元[23.29–82.26] ）。医生最重视避免每周一次低血糖（WTP：287.18欧元[95％置信区间：160.31-1,387.21]），其次是避免体重增加3 kg / 6个月并降低心血管风险（WTP：166.87欧元[88.63– 843.09]和€154.30 [98.13–434.19]）。为了避免糖化血红蛋白增加1％，医生和患者愿意分别支付125.92欧元（73.30–622.75）和24.28欧元（18.41–30.31），以及143.30欧元（73.39–543.62）和42.74欧元（23.89–61.77）。结论）：西班牙和葡萄牙的患者和医生都愿意为改善糖尿病治疗带来的健康益处付费，其中最重要的是避免低血糖和体重增加。降低心血管疾病风险和减轻体重分别成为医师和患者的第三大价值属性。

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