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首页> 外文期刊>Patient Preference and Adherence >Effect of pill burden on dosing preferences, willingness to pay, and likely adherence among patients with type 2 diabetes
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Effect of pill burden on dosing preferences, willingness to pay, and likely adherence among patients with type 2 diabetes

机译：药丸负荷对2型糖尿病患者的用药偏好，支付意愿以及可能的依从性的影响

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Purpose: To quantify willingness-to-pay (WTP) for reducing pill burden and dosing frequency among patients with type 2 diabetes mellitus (T2DM), and to examine the effect of dosing frequency and pill burden on likely medication adherence. Patients and methods: Participants were US adults with T2DM on oral antihyperglycemic therapy. Each patient completed an online discrete-choice experiment (DCE) with eight choice questions, each including a pair of hypothetical medication profiles. Each profile was defined by reduction in average glucose (AG), daily dosing, chance of mild-to-moderate stomach problems, frequency of hypoglycemia, weight change, incremental risk of congestive heart failure (CHF), and cost. Patients were asked to rate their likely adherence to the profiles presented in each question. Choice questions were based on a predetermined experimental design. Choice data were analyzed using random-parameters logit. Likely treatment adherence was analyzed using a Heckman two-stage model. Results: Of the 1,114 patients who completed the survey, 90 had lower dosing burden (<5 pills/day taken once/day or as needed) for all medications, and 1,024 had higher dosing burden (≥5 pills/day or more than once/day). Reduction in AG was valued most highly by patients. Hypoglycemia, chance of mild-to-moderate stomach problems, weight change, incremental risk of CHF, and daily dosing were less valued. Patients with higher current dosing burden had lower WTP for more convenient dosing schedules than patients with lower current dosing burden. Changes in dosing and cost impacted likely adherence. The magnitude of the impact of dosing on likely adherence was higher for patients with lower current dosing burden than for patients with higher current dosing burden. Conclusion: Patients with T2DM were willing to pay for improvements in efficacy, side effects, and dosing. Patients' WTP for more convenient dosing depended on current dosing burden, as did the effect of these attributes on likely adherence.
机译：目的：量化支付意愿（WTP）以减少2型糖尿病（T2DM）患者的药丸负担和给药频率，并检查给药频率和药丸负担对可能的药物依从性的影响。患者和方法：参与者为接受口服降糖治疗的美国成年人T2DM。每位患者通过八个选择题完成了一个在线离散选择实验（DCE），每个问题都包含一对假设的药物配置文件。通过降低平均血糖（AG），每日剂量，轻度至中度胃部疾病的机率，低血糖发生率，体重变化，充血性心力衰竭（CHF）的增加风险和成本来定义每种特征。要求患者对他们对每个问题中描述的特征的依从性进行评分。选择问题基于预定的实验设计。选择数据使用随机参数logit进行分析。使用Heckman两阶段模型分析可能的治疗依从性。结果：完成调查的1,114位患者中，有90位患者的所有药物的剂量负担较低（<5丸/天一次/每天或根据需要服用），而1,024位患者的药物负担较高（≥5丸/天或一天以上） /天）。患者对AG降低的评价最高。低血糖，轻度至中度胃部疾病的机会，体重变化，CHF的增加风险以及每日给药的价值较低。当前剂量负担较高的患者与更低电流剂量负担的患者相比，WTP较低，以便于更方便的剂量计划。剂量和成本的变化影响了依从性。当前剂量负担较低的患者的剂量对可能依从性的影响程度要高于当前剂量负担较高的患者。结论：T2DM患者愿意为改善疗效，副作用和剂量而付费。患者的WTP是否需要更方便的剂量取决于当前的剂量负担，以及这些属性对可能依从性的影响。

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