患结核病风险较高的人群的治疗偏好:一个离散选择实验
Wala Kamchedzera1, Matthew Quaife2, Wezi Msukwa-Panje1
1Public Health Research Group, Malawi-Liverpool Wellcome Clinical Research Programme, Blantyre, Malawi.
PLOS global public health
|July 19, 2024
概括
放射性明显但细菌学上阴性结核病患者更喜欢停止传播和减少疾病的治疗方法. 了解这些偏好是有效,以人为中心的结核病护理策略的关键.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 医疗保健服务研究 医疗服务研究
背景情况:
- 细菌学上阴性,放射学上明显的结核病 (TB) 提出了诊断和治疗方面的挑战.
- 对这一结核病亚组的最佳治疗策略尚未明确定义.
- 了解患者的偏好对于实施有效,以人为中心的结核病护理至关重要.
研究的目的:
- 调查结核病症状但细菌学阴性但放射学结果阳性的成年人治疗偏好.
- 为这个特定的结核病群体提供以患者为中心的治疗方法的发展信息.
主要方法:
- 一个离散选择实验 (DCE) 在马拉维布兰泰尔 (Blantyre) 对128名成年参与者进行.
- 参与者根据持续时间,疗效,传播风险,副作用,随访和成本等属性评估了治疗选择.
- 量化选择建模,包括多项逻辑模型,用于分析偏好.
主要成果:
- 参与者强烈偏爱任何治疗,而不是没有治疗,并偏爱具有较高风险降低的治疗 (80%对50%).
- 阻止传播是首要任务,避免副作用也是首要任务.
- 没有发现对95%有效的治疗方法的偏好超过80%有效的治疗方法,感知到的疾病风险没有影响偏好.
结论:
- 患者对结核病治疗的偏好主要取决于治疗的有效性和防止进一步传播的能力.
- 将患者的偏好纳入治疗策略设计中,对于接受和利用结核病护理至关重要.
- 这项研究支持转向更个性化,更有效的结核病管理.
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