肾移植受者治疗多瘤病毒感染的偏好：以患者、护理人员和临床医生为对象的离散选择实验。

IF 2.6 4区医学 Q3 IMMUNOLOGY

Transplant Infectious Disease Pub Date : 2024-10-22 DOI:10.1111/tid.14390

Chanel H Chong, Germaine Wong, Eric H Au, Nicole Scholes-Robertson, Shyamsundar Muthuramalingam, Simon D Roger, Karen Keung, Allison Jaure, Armando Teixeira-Pinto, Martin Howell

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引用次数: 0

摘要

背景：临床医生对肾移植受者BK多瘤病毒（BKPyV）感染的治疗策略不尽相同。我们旨在确定主要利益相关者对 BKPyV 感染的治疗偏好，并衡量治疗结果之间的权衡：方法：成人肾移植受者、护理人员和临床医生有资格参与 2021 年 2 月至 2022 年 6 月期间的离散选择实验。五个与治疗相关的属性是实现病毒清除和最佳移植物功能，以及降低移植物丢失、急性排斥反应和并发症的风险。结果采用多叉逻辑模型进行分析：结果：共纳入了 109 名参与者（57 名肾移植受者、10 名护理人员和 42 名医疗专业人员）。最重要的因素是移植物丢失的风险，其次是副作用和急性排斥反应。随着移植物丢失风险的增加，所有参与者都不太愿意接受指定的治疗策略。例如，如果移植物损失风险从1%增加到50%，那么接受BKPyV感染治疗策略的概率就会从87%下降到3%：结论：在决定 BKPyV 感染的治疗方法时，移植物损失是患者、护理人员和医疗专业人员最关心的问题，因此应将移植物损失纳入 BKPyV 感染的干预试验中。

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Preferences in treating polyomavirus infection in kidney transplant recipients: A discrete choice experiment with patients, caregivers, and clinicians.

Background: Treatment strategies for BK polyomavirus (BKPyV) infection in kidney transplant recipients are heterogeneous among clinicians. We aimed to identify the treatment preferences of key stakeholders for BKPyV infection and measure the trade-offs between treatment outcomes.

Methods: Adult kidney transplant recipients, caregivers, and clinicians were eligible to participate in a discrete choice experiment between February 2021 and June 2022. The five treatment-related attributes were achieving viral clearance and optimal graft function, as well as reducing the risk of graft loss, acute rejection, and complications. Results were analyzed using multinomial logistic models.

Results: In total, 109 participants (57 kidney transplant recipients, 10 caregivers, and 42 health professionals) were included. The most important attribute was the risk of graft loss, followed by side effects and acute rejection. As the risk of graft loss increased, all participants were less inclined to accept an assigned treatment strategy. For instance, if graft loss risk was increased from 1% to 50%, the probability of uptake of a treatment strategy for BKPyV infection was reduced from 87% to 3%.

Conclusion: Graft loss is the predominant concern for patients, caregivers, and health professionals when deciding on the treatment for BKPyV infection, and should be included in intervention trials of BKPyV infection.

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来源期刊

Transplant Infectious Disease 医学-传染病学

CiteScore

5.30

自引率

7.70%

发文量

210

审稿时长

4-8 weeks

期刊介绍： Transplant Infectious Disease has been established as a forum for presenting the most current information on the prevention and treatment of infection complicating organ and bone marrow transplantation. The point of view of the journal is that infection and allograft rejection (or graft-versus-host disease) are closely intertwined, and that advances in one area will have immediate consequences on the other. The interaction of the transplant recipient with potential microbial invaders, the impact of immunosuppressive strategies on this interaction, and the effects of cytokines, growth factors, and chemokines liberated during the course of infections, rejection, or graft-versus-host disease are central to the interests and mission of this journal. Transplant Infectious Disease is aimed at disseminating the latest information relevant to the infectious disease complications of transplantation to clinicians and scientists involved in bone marrow, kidney, liver, heart, lung, intestinal, and pancreatic transplantation. The infectious disease consequences and concerns regarding innovative transplant strategies, from novel immunosuppressive agents to xenotransplantation, are very much a concern of this journal. In addition, this journal feels a particular responsibility to inform primary care practitioners in the community, who increasingly are sharing the responsibility for the care of these patients, of the special considerations regarding the prevention and treatment of infection in transplant recipients. As exemplified by the international editorial board, articles are sought throughout the world that address both general issues and those of a more restricted geographic import.