中国全科医学 ›› 2025, Vol. 28 ›› Issue (36): 4648-4654.DOI: 10.12114/j.issn.1007-9572.2024.0585

• 综述与专论 • 上一篇    

利用离散选择试验测量慢性阻塞性肺疾病患者治疗与装置偏好的综述

邵家琛1,2,3, 李顺平1,2,3,*(), 杨汀4,5, 张春瑜4,5, 路立勇1,2,3, 袁佳麒1,2,3   

  1. 1.250012 山东省济南市,山东大学齐鲁医学院公共卫生学院卫生管理与政策研究中心
    2.250012 山东省济南市,国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学)
    3.250012 山东省济南市,山东大学健康偏好研究中心
    4.100029 北京市,中日友好医院呼吸中心呼吸与危重症医学科
    5.100029 北京市,国家呼吸医学中心 中国医学科学院呼吸病学研究院 国家呼吸疾病临床医学研究中心
  • 收稿日期:2024-11-21 修回日期:2025-02-12 出版日期:2025-12-20 发布日期:2025-12-04
  • 通讯作者: 李顺平

  • 作者贡献:

    邵家琛、李顺平、杨汀进行文章的构思与设计;邵家琛进行文献检索和信息提取;邵家琛、李顺平撰写论文及修订;张春瑜、路立勇、袁佳麒进行质量控制及审校;邵家琛、李顺平对文章整体负责,监督管理。

  • 基金资助:
    国家自然科学基金资助项目(72374127); 山东省自然科学基金项目(ZR2024QG156)

A Review of Discrete Choice Experiment in Treatment and Device Preferences for Chronic Obstructive Pulmonary Disease

SHAO Jiachen1,2,3, LI Shunping1,2,3,*(), YANG Ting4,5, ZHANG Chunyu4,5, LU Liyong1,2,3, YUAN Jiaqi1,2,3   

  1. 1. Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
    2. NHC Key Lab of Health Economics and Policy Research (Shandong University) , Jinan 250012, China
    3. Center for Health Preference Research, Shandong University, Jinan 250012, China
    4. Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, China
    5. National Center for Respiratory Medicine/Institute of Respiratory Medicine, Chinese Academy of Medical Sciences/National Clinical Research Center for Respiratory Disease, Beijing 100029, China
  • Received:2024-11-21 Revised:2025-02-12 Published:2025-12-20 Online:2025-12-04
  • Contact: LI Shunping

摘要: 背景 慢性阻塞性肺疾病(COPD)疾病负担沉重,不同治疗方案的属性不同,影响患者的依从性,进而影响治疗效果,离散选择试验既能确定影响患者选择的重要因素(属性),又能确定患者最为看重的属性,以及各属性间的权衡程度,已广泛应用于医药卫生领域。 目的 回顾与评估离散选择试验在COPD患者对治疗与装置偏好研究文献,以期为国内开展COPD患者健康偏好相关研究提供参考。 方法 在Web of Science、PubMed、中国知网、维普网、中国生物医学文献数据库、万方数据知识服务平台检索利用离散选择试验测量COPD患者健康偏好的文献,使用PREFS评估清单进行文献质量评估,对研究中出现属性及所属维度进行分析讨论。 结果 最终纳入11篇文献,均来自欧美发达国家,属性的设定因研究目的及对象的不同而存在显著差异。针对治疗偏好,疗效、便利性、治疗负担、风险和患者特征包含属性的数量分别占29%、29%、20%、11%和11%,COPD患者尤为偏好疗效和风险维度的属性,其次是治疗负担和患者特征,便利性维度关注度较低;针对吸入装置偏好,特征设计、装置使用和药物搭配包含属性的数量分别占36%、32%和32%,COPD患者尤为偏好特征设计与药物搭配维度的属性,其次是装置使用,文献质量相对一般。 结论 各维度的纳入属性频率与患者最为偏好的维度之间不呈正比,尤其是治疗方案中对便利性维度的偏好最低;目前我国仍未有离散选择试验在COPD中的应用研究,今后应立足我国实际开展更多相关研究,为COPD治疗的改善提供依据。

关键词: 肺疾病,慢性阻塞性, 治疗偏好, 装置偏好, 离散选择试验

Abstract:

Background

Chronic obstructive pulmonary disease (COPD) is associated with a substantial disease burden. The attributes of different treatment options vary, which can affect patient adherence and, consequently, treatment outcomes. Discrete choice experiment (DCE) can identify the key factors (attributes) influencing patient choices, determine the most valued attributes, and quantify the trade-offs between attributes. DCEs have been widely applied in the healthcare field.

Objective

To review and evaluate the literature on DCE regarding treatment and device preferences among patients with COPD, with the aim of providing a reference for conducting health preference-related research on COPD patients in China.

Methods

Literature utilizing DCEs to measure health preferences among patients with COPD was retrieved from the Web of Science Core Collection, PubMed, CNKI, Wanfang Data, CBM, and VIP Database. The PREFS checklist was employed for quality evaluation. The attributes in the studies and their corresponding dimensions were analyzed and discussed.

Results

A total of 11 studies were included, all from developed countries. Significant differences were observed in the attributes due to variations in research objectives and subjects. Regarding treatment preferences, the proportions of attributes related to efficacy, convenience, treatment burden, risk, and patient characteristics were 29%, 29%, 20%, 11%, and 11%, respectively. Patients with COPD particularly preferred attributes related to efficacy and risk dimensions, followed by treatment burden and patient characteristics, with less emphasis on convenience. For device preferences, the proportions of attributes related to feature design, device usage, and drug-related features were 36%, 32%, and 32%. COPD patients showed a strong preference for attributes related to device design and drug related features, followed by device use. The overall quality of the literature was not relatively high.

Conclusion

There is a discrepancy between the frequency of attributes included in each dimension and the dimensions preferred by patients, particularly with the convenience dimension being the least preferred in treatments. To date, there is no application of DCEs among COPD patients in China. In the future, more relevant research should be carried out based on the actual situation in China to provide evidence for the improvement of COPD treatment.

Key words: Pulmonary disease, chronic obstructive, Treatment preference, Device preference, Discrete choice experiment