Hemodialysis patients’ preferences for the management of anemia

BMC Nephrology

Research Article

John Caloyeras¹  Allan Pollock¹  Spiros Tzivelekis¹  Deborah Brommage²  Brett Hauber³  Joshua Posner³ 

[1] Amgen, Thousand Oaks, CA, USA;National Kidney Foundation, New York, NY, USA;RTI Health Solutions, 200 Park Offices Drive, Research Triangle Park, NC, USA;

关键词: Anemia;    End-stage renal disease;    Discrete-choice experiment;    Conjoint analysis;   

DOI  :  10.1186/s12882-017-0664-9

 received in 2016-10-21, accepted in 2017-07-14,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundPatient engagement in end-stage renal disease (ESRD) is expected to result in a more patient-centered approach to care that aligns with patients’ values, preferences, and goals for treatment. Nevertheless, no previous studies of which we are aware have evaluated patients’ benefit-risk preferences for the management of anemia associated with ESRD. The primary objective of this study was to quantify the tradeoffs patients are willing to make between cardiovascular risks associated with some anemia medicines and red blood cell (RBC) transfusions. A secondary objective was to quantify the importance of avoiding transfusion-related risks.MethodsA survey instrument was developed from the clinical literature, clinician input, patient-education resources, and a patient focus group. The survey instrument was qualitatively pretested before its administration to a broader sample of patients. The National Kidney Foundation invited individuals in the United States to participate in the survey. In a discrete-choice experiment (DCE), respondents chose between two hypothetical anemia medications in a series of questions. Each medication was defined by symptom relief, frequency of transfusions, cardiovascular risk, mode of administration, and out-of-pocket cost. The survey also included a best-worst scaling (BWS) exercise to quantify the importance of avoiding attributes of blood transfusions. Results from the DCE were used to estimate relative importance and marginal willingness to pay. Results from the BWS were converted to relative importance weights.ResultsA total of 200 individuals completed the survey. Patients were willing to accept a 6% medication-related risk of heart attack to avoid having two RBC transfusions per month. Symptom relief and mode of administration were of moderate importance. The most important transfusion-related risk to avoid was transfusion-related lung injury.ConclusionsPatients with ESRD and anemia have measurable treatment preferences and are willing to accept risks associated with anemia medications to avoid transfusions.

【 授权许可】

CC BY   
© The Author(s). 2017