了解三回患者的治疗偏好
Vijay Iyer1, Nadeen N Faza2, Michael Pfeiffer3
1Division of Cardiology, Buffalo General Medical Center, Buffalo, NY, USA.
MDM policy & practice
|January 22, 2024
概括
三管吐 (TR) 患者优先考虑缓解症状,特别是呼吸短促,而不是程序风险. 他们接受更高的再干预风险,以有效缓解症状,特别是老年人和更有症状的人.
科学领域:
- 心血管医学 心血管医学
- 患者报告的结果
- 卫生经济学 卫生经济学
背景情况:
- 三管吐 (TR) 是一种普遍的疾病,与生活质量下降和死亡率增加有关.
- 了解患者对TR治疗中风险益处权衡的偏好,对于治疗开发至关重要.
研究的目的:
- 量化评估三回患者在治疗选择中的风险和益处权衡的观点.
- 确定影响患者关于TR管理的决策的关键属性.
主要方法:
- 使用一个离散选择实验,在线调查150名TR患者.
- 评估的关键属性包括治疗类型,重新干预的风险,药物变化,呼吸短促和胀.
- 混合逻辑回归分析被用来建模患者的偏好和属性重要性.
主要成果:
- 呼吸短促是TR患者治疗决策中最重要的因素 (65.8%).
- 患者表现出强烈的偏好 (99.7%) 对类似程序的个人资料,而不是医疗管理的个人资料.
- 呼吸短促的严重程度下降显著增加了对治疗的偏好,即使再干预风险更高.
结论:
- 三管吐患者愿意接受更大的程序性重新干预风险,以缓解呼吸困难.
- 当症状负担得到解决时,老年和更有症状的患者对手术风险的耐受性更高.
- 这些发现支持开发专注于缓解患者症状的新型TR疗法.
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