Is Three a Crowd? The Influence of Companions on a Patient's Decision to Transition to a Biosimilar.

Chiara Gasteiger, Katie M Groom, Maria Lobo, Urte Scholz, Nicola Dalbeth, Keith J Petrie
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引用次数: 3

Abstract

Background: Involving patients in treatment decisions is commonplace in healthcare, and patients are frequently accompanied by a companion (support person). Companions are often actively involved in medical consultations, yet their impact on decisions to change medications is unknown.

Purpose: This study examines the influence of companions on a patient's decision to transition from their bio-originator therapy to a biosimilar.

Methods: A parallel, two-arm randomized controlled trial was conducted with 79 patients taking a bio-originator for rheumatic diseases who regularly attend clinic with a companion. Patients were randomized to receive an explanation about a hypothetical transition to a biosimilar alone or with their companion. Patients reported willingness to transition, risk perceptions, difficulty understanding, social support, and completed the Decisional Conflict Scale and Satisfaction with Decision Scale.

Results: Companions did not influence decisions to transition to biosimilars or cognitive and affective risk perceptions. Accompanied patients reported more difficulty understanding the explanation (p = .006, Cohen's d = .64) but thought it was more important to receive information with companions (p = .023, Cohen's d = -.52). Companions did not impact decision satisfaction or decisional conflict. Receiving emotional, but not practical support, was associated with less decisional conflict in accompanied patients (p = .038, r2 = 0.20).

Conclusions: The presence of companions does not seem to influence risk perceptions or decisions about transitioning to biosimilars. Companions, however, impact the patient's reporting of their ability to understand treatment explanations. Providers should check understanding in all patients but may need to provide additional time or educational resources to accompanied patients and companions.

Trial registration: Australian New Zealand Clinical Trial Registry: ACTRN12619001435178.

三个人是一群人吗?同伴对患者转向生物仿制药决定的影响。
背景:在医疗保健中,让患者参与治疗决策是司空见惯的,患者经常有同伴(支持人员)陪同。同伴经常积极参与医疗咨询,但他们对改变药物决定的影响尚不清楚。目的:本研究考察同伴对患者决定从生物原研药物转向生物仿制药的影响。方法:采用平行、双组随机对照试验,对79例服用风湿生物制剂并有伴定期就诊的患者进行研究。患者被随机分配,接受关于单独或与同伴一起过渡到生物仿制药的假设解释。患者报告转变意愿、风险感知、理解困难、社会支持,并完成决策冲突量表和决策满意度量表。结果:同伴不影响转向生物仿制药的决定或认知和情感风险感知。陪伴的患者报告更难以理解解释(p = 0.006, Cohen’s d = 0.64),但认为与同伴一起接受信息更重要(p = 0.023, Cohen’s d = - 0.52)。同伴并不影响决策满意度或决策冲突。在陪同患者中,接受情感支持而非实际支持与较少的决策冲突相关(p = 0.038, r2 = 0.20)。结论:同伴的存在似乎并不影响风险感知或对过渡到生物仿制药的决定。然而,同伴会影响患者报告他们理解治疗解释的能力。提供者应检查所有患者的理解情况,但可能需要为陪同的患者和同伴提供额外的时间或教育资源。试验注册:澳大利亚新西兰临床试验注册:ACTRN12619001435178。
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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