{"title":"对格雷夫斯病管理和治疗的患者偏好、期望和价值的系统回顾。","authors":"Yingjie Chen, Zonghao Ren, Xiujuan Zhou, Peiyang Gao","doi":"10.2147/PPA.S540261","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To systematically synthesize evidence on treatment preferences, values, and expectations among patients with Graves' disease (GD), in order to understand the disease's impact on quality of life and inform clinical decision-making..</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science, and Cochrane Library were searched for articles about GD, patient preferences, and expectations from database inception to December 2024. Studies included in the review must report raw data on patient-reported outcomes, preferences or experiences relating to GD, and must undergo quality assessment according to the Agency for Healthcare Research and Quality (AHRQ).</p><p><strong>Results: </strong>Twenty-one studies involving patients with GD were included. Although preferences varied, several trends emerged: 1) Most patients reported that GD significantly disrupted their quality of life and social functioning, with 60% experiencing severe discomfort. 2) Antithyroid drugs (ATD) was the most preferred initial treatment (64%), followed by surgery (25%) and radioactive iodine therapy (RAI) (11%), with concerns about radioactivity and surgical complications influencing decisions. 3) Key factors affecting treatment choices included remission rates, recovery time, impact on daily life, and physician recommendations. 4) Graves' ophthalmopathy (GO) patients faced additional challenges, including social withdrawal and appearance-related distress, with female patients expressing greater concern about disfigurement.</p><p><strong>Conclusion: </strong>This systematic review indicates that GD, particularly GO, significantly impairs patients' self-confidence, quality of life, and social functioning. Treatment choices are influenced by expected outcomes, personal circumstances, psychological concerns, and economic factors. ATD remains the preferred first-line treatment, though individual preferences vary significantly, emphasizing the importance of personalized approaches and decision aids.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"19 ","pages":"2949-2957"},"PeriodicalIF":2.0000,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456433/pdf/","citationCount":"0","resultStr":"{\"title\":\"A Systematic Review of Patient Preferences, Expectations, and Values for the Management and Treatment of Graves Disease.\",\"authors\":\"Yingjie Chen, Zonghao Ren, Xiujuan Zhou, Peiyang Gao\",\"doi\":\"10.2147/PPA.S540261\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To systematically synthesize evidence on treatment preferences, values, and expectations among patients with Graves' disease (GD), in order to understand the disease's impact on quality of life and inform clinical decision-making..</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science, and Cochrane Library were searched for articles about GD, patient preferences, and expectations from database inception to December 2024. Studies included in the review must report raw data on patient-reported outcomes, preferences or experiences relating to GD, and must undergo quality assessment according to the Agency for Healthcare Research and Quality (AHRQ).</p><p><strong>Results: </strong>Twenty-one studies involving patients with GD were included. Although preferences varied, several trends emerged: 1) Most patients reported that GD significantly disrupted their quality of life and social functioning, with 60% experiencing severe discomfort. 2) Antithyroid drugs (ATD) was the most preferred initial treatment (64%), followed by surgery (25%) and radioactive iodine therapy (RAI) (11%), with concerns about radioactivity and surgical complications influencing decisions. 3) Key factors affecting treatment choices included remission rates, recovery time, impact on daily life, and physician recommendations. 4) Graves' ophthalmopathy (GO) patients faced additional challenges, including social withdrawal and appearance-related distress, with female patients expressing greater concern about disfigurement.</p><p><strong>Conclusion: </strong>This systematic review indicates that GD, particularly GO, significantly impairs patients' self-confidence, quality of life, and social functioning. Treatment choices are influenced by expected outcomes, personal circumstances, psychological concerns, and economic factors. ATD remains the preferred first-line treatment, though individual preferences vary significantly, emphasizing the importance of personalized approaches and decision aids.</p>\",\"PeriodicalId\":19972,\"journal\":{\"name\":\"Patient preference and adherence\",\"volume\":\"19 \",\"pages\":\"2949-2957\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-09-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456433/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Patient preference and adherence\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/PPA.S540261\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Patient preference and adherence","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/PPA.S540261","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
目的：系统地综合格雷夫斯病（GD）患者的治疗偏好、价值观和期望的证据，以了解该病对生活质量的影响，为临床决策提供依据。方法：检索PubMed、Embase、Web of Science和Cochrane Library从数据库建立到2024年12月关于GD、患者偏好和期望的文章。纳入审查的研究必须报告患者报告的结果、偏好或与GD相关的经历的原始数据，并且必须根据医疗保健研究和质量机构（AHRQ）进行质量评估。结果：纳入了21项涉及GD患者的研究。尽管偏好各不相同，但出现了几个趋势：1)大多数患者报告说，焦虑严重影响了他们的生活质量和社会功能，60%的患者经历了严重的不适。2)抗甲状腺药物（ATD）是首选的初始治疗（64%），其次是手术（25%）和放射性碘治疗（RAI）（11%），对放射性和手术并发症的担忧影响了决定。3)影响治疗选择的关键因素包括缓解率、恢复时间、对日常生活的影响和医生建议。4) Graves眼病（GO）患者面临着更多的挑战，包括社交退缩和外貌相关的困扰，女性患者对毁容表现出更大的担忧。结论：本系统综述表明，GD，特别是GO，显著损害患者的自信心、生活质量和社会功能。治疗选择受预期结果、个人情况、心理问题和经济因素的影响。ATD仍然是首选的一线治疗，尽管个体偏好差异很大，强调个性化方法和决策辅助的重要性。
A Systematic Review of Patient Preferences, Expectations, and Values for the Management and Treatment of Graves Disease.
Objective: To systematically synthesize evidence on treatment preferences, values, and expectations among patients with Graves' disease (GD), in order to understand the disease's impact on quality of life and inform clinical decision-making..
Methods: PubMed, Embase, Web of Science, and Cochrane Library were searched for articles about GD, patient preferences, and expectations from database inception to December 2024. Studies included in the review must report raw data on patient-reported outcomes, preferences or experiences relating to GD, and must undergo quality assessment according to the Agency for Healthcare Research and Quality (AHRQ).
Results: Twenty-one studies involving patients with GD were included. Although preferences varied, several trends emerged: 1) Most patients reported that GD significantly disrupted their quality of life and social functioning, with 60% experiencing severe discomfort. 2) Antithyroid drugs (ATD) was the most preferred initial treatment (64%), followed by surgery (25%) and radioactive iodine therapy (RAI) (11%), with concerns about radioactivity and surgical complications influencing decisions. 3) Key factors affecting treatment choices included remission rates, recovery time, impact on daily life, and physician recommendations. 4) Graves' ophthalmopathy (GO) patients faced additional challenges, including social withdrawal and appearance-related distress, with female patients expressing greater concern about disfigurement.
Conclusion: This systematic review indicates that GD, particularly GO, significantly impairs patients' self-confidence, quality of life, and social functioning. Treatment choices are influenced by expected outcomes, personal circumstances, psychological concerns, and economic factors. ATD remains the preferred first-line treatment, though individual preferences vary significantly, emphasizing the importance of personalized approaches and decision aids.
期刊介绍：
Patient Preference and Adherence is an international, peer reviewed, open access journal that focuses on the growing importance of patient preference and adherence throughout the therapeutic continuum. The journal is characterized by the rapid reporting of reviews, original research, modeling and clinical studies across all therapeutic areas. Patient satisfaction, acceptability, quality of life, compliance, persistence and their role in developing new therapeutic modalities and compounds to optimize clinical outcomes for existing disease states are major areas of interest for the journal.
As of 1st April 2019, Patient Preference and Adherence will no longer consider meta-analyses for publication.
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