Association of medication adherence with treatment preferences: incentivizing truthful self-reporting.

IF 3.1 3区 医学 Q1 ECONOMICS
Carina Oedingen, Raf van Gestel, Samare P I Huls, Georg Granic, Esther W de Bekker-Grob, Jorien Veldwijk
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引用次数: 0

Abstract

Objective: Self-reported medication adherence may be influenced by socially desirable answers and untruthful reporting. Misreporting of adherence behavior can bias estimations of treatment (cost)effectiveness. This study investigated how to induce truthful self-reported medication adherence and evaluated how self-reported (truth-induced vs. regularly reported) medication adherence and treatment preferences were associated.

Methods: Medication adherence was measured after a discrete choice experiment eliciting stated preferences for Multiple Sclerosis (MS)-treatments. Data was collected among MS-patients in three Western countries. Half of the sample was randomized to 'choice-matching', a novel mechanism which induces truthfulness. It financially compensates respondents based on their self-reported adherence and guesses about other respondents' adherence. To investigate the impact of truth-incentivized adherence reporting on preference heterogeneity, interaction effects between medication adherence and treatment preferences were tested separately within the choice-matching and the 'standard' group.

Results: The sample comprised 380 MS-patients (mean age 41y, 69% female). Respondents in the choice-matching group reported a lower medication adherence compared to the standard group (always adherent: 39.3% vs. 46.6%). Mixed logit models showed significant interaction effects: in the choice-matching group, higher medication adherence resulted in lower utility for pills twice/day compared to injections three times/week (p = 0.019), while in the standard group, respondents with higher medication adherence preferred pills once/day compared to injections three times/week (p = 0.005).

Conclusion: Choice-matching likely encouraged respondents to report their true medication adherence. Linking truthful behavior to patients' preferences allows for a better understanding of preference heterogeneity and helping to make decisions that fit patients' true preferences.

药物依从性与治疗偏好的关系:激励真实的自我报告。
目的:自我报告的药物依从性可能受到社会期望答案和不真实报告的影响。依从性行为的误报会使治疗(成本)效果的估计产生偏差。本研究探讨了如何诱导真实自我报告的药物依从性,并评估了自我报告(真实诱导与定期报告)药物依从性与治疗偏好之间的关系。方法:在离散选择实验后,对多发性硬化症(MS)治疗的偏好进行测量。数据收集自三个西方国家的多发性硬化症患者。一半的样本被随机分配到“选择匹配”,这是一种诱导诚实的新机制。它根据受访者自我报告的坚持程度和对其他受访者坚持程度的猜测,对受访者进行经济补偿。为了研究真相激励依从性报告对偏好异质性的影响,在选择匹配组和“标准”组中分别测试了药物依从性和治疗偏好之间的相互作用效应。结果:样本包括380例ms患者(平均年龄41岁,69%为女性)。与标准组相比,选择匹配组的应答者报告了较低的药物依从性(始终坚持:39.3%对46.6%)。混合logit模型显示了显著的相互作用效应:在选择匹配组中,较高的药物依从性导致每天两次药丸的效用低于注射三次/周(p = 0.019),而在标准组中,较高药物依从性的受访者更倾向于每天一次药丸而不是注射三次/周(p = 0.005)。结论:选择匹配可能鼓励受访者报告他们真正的药物依从性。将真实的行为与患者的偏好联系起来,可以更好地理解偏好的异质性,并有助于做出符合患者真实偏好的决定。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.10
自引率
2.30%
发文量
131
期刊介绍: The European Journal of Health Economics is a journal of Health Economics and associated disciplines. The growing demand for health economics and the introduction of new guidelines in various European countries were the motivation to generate a highly scientific and at the same time practice oriented journal considering the requirements of various health care systems in Europe. The international scientific board of opinion leaders guarantees high-quality, peer-reviewed publications as well as articles for pragmatic approaches in the field of health economics. We intend to cover all aspects of health economics: • Basics of health economic approaches and methods • Pharmacoeconomics • Health Care Systems • Pricing and Reimbursement Systems • Quality-of-Life-Studies The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfill the above-mentioned requirements. Officially cited as: Eur J Health Econ
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