干预研究中偏好的影响:范围综述

S. Sidani
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摘要

导言:考虑治疗偏好在实践中是有益的,它增加了对治疗的依从性并改善了健康结果。随机对照试验(RCT)被认为在产生有效性的有效证据方面是最可靠的,但它忽略了参与者对治疗的偏好。本综述涉及三个问题:1)干预研究中治疗偏好是如何概念化的?2)治疗偏好在多大程度上影响受试者入组试验、退出研究、坚持治疗和结局?3)在干预评估研究中使用什么设计来解释治疗偏好?方法:应用范围审查方法学框架的前五个步骤:1)确定研究问题;2)文献检索;3)选择文章;4)制图数据;5)总结研究结果。结果:治疗偏好指选择治疗;它们是由参与者的信念和对干预措施的评价形成的。来自综述和初步研究的证据表明,为参与者提供选择和接受首选治疗的机会可以提高入组率,减少试验中的退出;然而,关于治疗偏好对治疗依从性和结果改善的影响的证据尚无定论。考虑治疗偏好的设计包括:随机对照试验、综合队列随机对照试验、部分随机偏好试验和两阶段部分随机试验。结论:结果的模式可能归因于评估治疗偏好的方法。推荐一种评估偏好的系统方法。
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Influence of preferences in intervention research: A scoping review
Introduction: Accounting for treatment preferences is beneficial in practice, it increases adherence to treatment and improves health outcomes. The randomized controlled trial (RCT) is considered the most robust in generating valid evidence on effectiveness, yet it ignores participants’ preferences for treatment. This scoping review addressed three questions: 1) How are treatment preferences conceptualized in intervention research? 2) To what extent do treatment preferences affect participants’ enrollment in trials, withdrawal from the study, adherence to treatment, and outcomes? And 3) What designs are used to account for treatment preferences in intervention evaluation research? Methods: The first five steps of the scoping review methodology framework were applied: 1) identifying the research questions; 2) searching the literature; 3) selecting articles; 4) charting data; and 5) summarizing findings. Results: Treatment preferences refer to choice treatment; they are shaped by participants’ beliefs and appraisal of the interventions. Evidence from reviews and primary studies indicated that offering participants the opportunity to choose and receive the preferred treatment enhances enrollment and reduces withdrawal in trials; however, the evidence regarding the influence of treatment preferences on adherence to treatment and improvement in outcomes is inconclusive. Designs that account for treatment preferences include: RCT, RCT with a comprehensive cohort, partially randomized preference trial, and two-stage partially randomized trial. Conclusion: The pattern of results may be attributed to the methods for assessing treatment preferences. A systematic method for assessing preferences is recommended.
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