评估住院糖尿病患者对全院血糖控制计划的偏好:离散选择实验

IF 3.6 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Journal of Diabetes Research Pub Date : 2024-09-06 DOI:10.1155/2024/2552658
Jing Dai,Ting He,Xiaodie He,Huaying Li,Lintong Li,Jie Sun,Jie Pan,Cheng Ji
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引用次数: 0

摘要

背景:有效控制血糖对住院患者至关重要,可缩短住院时间并降低术后感染率。虽然以往的研究强调了多学科协作管理对全院高血糖管理的有效性,但患者的观点和偏好尚未得到充分考虑。研究目的利用离散选择实验(DCEs)确定影响中国住院糖尿病患者治疗偏好的因素,为构建全院血糖控制计划提供实用见解。调查方法对南京一家三级甲等医院非内分泌科住院的糖尿病患者进行面对面调查。根据 DCE 原则确定属性和水平,并使用条件 logit 模型量化患者的偏好。研究结果共分析了 157 位受访者。抗高血糖效果、医疗服务提供者、治疗方案、监测频率和不良反应是显著影响患者偏好的五个属性(P < 0.05)。值得注意的是,80% 的血糖控制率(β = 2.009)和有临床药剂师参与的多学科管理团队(β = 1.346)影响最大。低血糖 (β = -1.008) 、胰岛素泵的使用 (β = -0.746) 和频繁的血糖监测 (β = -0.523)产生了负面影响。与男性相比,女性患者对医疗服务提供者的关注度更高(β = 1.172)。年轻患者和疗程较短的患者优先考虑降糖效果(β = 3.330, β = 1.510),而年长患者则倾向于多学科管理(β = 1.186),反对增加监测频率(β = -0.703)。教育背景较高的患者对持续血糖监测的接受度更高(β = 1.983),年收入较高的患者更重视血糖控制率。结论住院糖尿病患者的治疗偏好主要受降糖效果、不良反应、医疗服务提供者和个体特征的影响。在制定全院血糖控制计划时,应综合考虑并采取个体化治疗策略。
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Evaluating Preferences of Hospitalized Diabetes Patients for Hospital-Wide Glycemic Control Programme: A Discrete Choice Experiment.
Background: Effective glycemic control is crucial for hospitalized patients, leading to benefits such as shorter hospital stays and reduced postoperative infection rates. While previous studies have emphasized the effectiveness of multidisciplinary collaborative stewardship for hospital-wide hyperglycemia management, patient perspectives and preferences have not been adequately considered. Objective: To identify factors influencing treatment preferences of Chinese hospitalized diabetes patients using discrete choice experiments (DCEs) and provide practical insights for the construction of a hospital-wide glycemic control programme. Methods: A face-to-face survey was conducted among diabetes patients admitted to nonendocrine departments in a tertiary hospital in Nanjing, China. The attributes and levels were determined based on DCE principles, and a conditional logit model was used to quantify patients' preferences. Results: A total of 157 respondents were analyzed. Antihyperglycemic effectiveness, healthcare providers, treatment regimen, monitoring frequency, and adverse reactions were the five attributes that significantly influenced patient preference (p < 0.05). Notably, an 80% glycemic control rate (β = 2.009) and a multidisciplinary management team involving clinical pharmacists (β = 1.346) had the greatest impact. Negative effects were observed for hypoglycemia (β = -1.008), insulin pump use (β = -0.746), and frequent glucose monitoring (β = -0.523). Female patients exhibited higher concern for healthcare providers (β = 1.172) compared to males. Younger and shorter-course patients prioritized antihyperglycemic effectiveness (β = 3.330, β = 1.510), while older patients preferred multidisciplinary management (β = 1.186) and opposed increased monitoring frequency (β = -0.703). Patients with higher educational backgrounds showed greater acceptance of continuous glucose monitoring (β = 1.983), and those with higher annual income placed more emphasis on glycemic control rate. Conclusion: Treatment preferences of hospitalized diabetes patients are mainly influenced by antihyperglycemic effectiveness, adverse reactions, healthcare providers, and individual characteristics. Comprehensive consideration and an individualized therapy strategy should be given when constructing a hospital-wide glycemic control programme.
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来源期刊
Journal of Diabetes Research
Journal of Diabetes Research ENDOCRINOLOGY & METABOLISM-MEDICINE, RESEARCH & EXPERIMENTAL
CiteScore
8.40
自引率
2.30%
发文量
152
审稿时长
14 weeks
期刊介绍: Journal of Diabetes Research is a peer-reviewed, Open Access journal that publishes research articles, review articles, and clinical studies related to type 1 and type 2 diabetes. The journal welcomes submissions focusing on the epidemiology, etiology, pathogenesis, management, and prevention of diabetes, as well as associated complications, such as diabetic retinopathy, neuropathy and nephropathy.
期刊最新文献
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