Hemodialysis patients’ preferences for the management of secondary hyperparathyroidism
Abstract Background Patient engagement and patient-centered care are critical in optimally managing patients with end-stage renal disease (ESRD). Understanding patient preferences is a key element of patient-centered care and shared decision making. The objective of this study was to elicit patients...
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doaj-136f618ebe0b4456bc8b54374ff9efb42020-11-24T21:46:02ZengBMCBMC Nephrology1471-23692017-07-0118111110.1186/s12882-017-0665-8Hemodialysis patients’ preferences for the management of secondary hyperparathyroidismBrett Hauber0John Caloyeras1Joshua Posner2Deborah Brommage3Vasily Belozeroff4Kerry Cooper5RTI Health SolutionsAmgenRTI Health SolutionsNational Kidney FoundationAmgenAmgenAbstract Background Patient engagement and patient-centered care are critical in optimally managing patients with end-stage renal disease (ESRD). Understanding patient preferences is a key element of patient-centered care and shared decision making. The objective of this study was to elicit patients’ preferences for the treatment of secondary hyperparathyroidism (SHPT) associated with ESRD using a discrete-choice experiment survey. Methods Clinical literature, nephrologist input, patient-education resources, and a patient focus group informed development of the survey instrument, which was qualitatively pretested before its administration to a broader sample of patients. The National Kidney Foundation invited individuals in the United States with ESRD who were undergoing hemodialysis to participate in the survey. Respondents chose among three hypothetical SHPT treatment alternatives (two medical alternatives and surgery) in each of a series of questions, which were defined by attributes of efficacy (effect on laboratory values and symptoms), safety, tolerability, mode of administration, and cost. The survey instrument included a best-worst scaling exercise to quantify the relative bother of the individual attributes of surgery. Random-parameters logit models were used to evaluate the conditional relative importance of the attributes. Results A total of 200 patients with ESRD completed the survey. The treatment attributes that were most important to the respondents were whether a treatment was a medication or surgery and out-of-pocket cost. Patients had statistically significant preferences for efficacy attributes related to symptom management and laboratory values, but placed less importance on the attributes related to mode of administration and side effects. The most bothersome attribute of surgery was the risk of surgical mortality. Conclusions Patients with ESRD and SHPT who are undergoing hemodialysis understand SHPT and have clear and measurable treatment preferences. These results may help inform clinicians about patients’ preferences regarding treatment options for a common complication of ESRD.http://link.springer.com/article/10.1186/s12882-017-0665-8Secondary hyperparathyroidismEnd-stage renal diseaseDiscrete-choice experimentConjoint analysis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Brett Hauber John Caloyeras Joshua Posner Deborah Brommage Vasily Belozeroff Kerry Cooper |
spellingShingle |
Brett Hauber John Caloyeras Joshua Posner Deborah Brommage Vasily Belozeroff Kerry Cooper Hemodialysis patients’ preferences for the management of secondary hyperparathyroidism BMC Nephrology Secondary hyperparathyroidism End-stage renal disease Discrete-choice experiment Conjoint analysis |
author_facet |
Brett Hauber John Caloyeras Joshua Posner Deborah Brommage Vasily Belozeroff Kerry Cooper |
author_sort |
Brett Hauber |
title |
Hemodialysis patients’ preferences for the management of secondary hyperparathyroidism |
title_short |
Hemodialysis patients’ preferences for the management of secondary hyperparathyroidism |
title_full |
Hemodialysis patients’ preferences for the management of secondary hyperparathyroidism |
title_fullStr |
Hemodialysis patients’ preferences for the management of secondary hyperparathyroidism |
title_full_unstemmed |
Hemodialysis patients’ preferences for the management of secondary hyperparathyroidism |
title_sort |
hemodialysis patients’ preferences for the management of secondary hyperparathyroidism |
publisher |
BMC |
series |
BMC Nephrology |
issn |
1471-2369 |
publishDate |
2017-07-01 |
description |
Abstract Background Patient engagement and patient-centered care are critical in optimally managing patients with end-stage renal disease (ESRD). Understanding patient preferences is a key element of patient-centered care and shared decision making. The objective of this study was to elicit patients’ preferences for the treatment of secondary hyperparathyroidism (SHPT) associated with ESRD using a discrete-choice experiment survey. Methods Clinical literature, nephrologist input, patient-education resources, and a patient focus group informed development of the survey instrument, which was qualitatively pretested before its administration to a broader sample of patients. The National Kidney Foundation invited individuals in the United States with ESRD who were undergoing hemodialysis to participate in the survey. Respondents chose among three hypothetical SHPT treatment alternatives (two medical alternatives and surgery) in each of a series of questions, which were defined by attributes of efficacy (effect on laboratory values and symptoms), safety, tolerability, mode of administration, and cost. The survey instrument included a best-worst scaling exercise to quantify the relative bother of the individual attributes of surgery. Random-parameters logit models were used to evaluate the conditional relative importance of the attributes. Results A total of 200 patients with ESRD completed the survey. The treatment attributes that were most important to the respondents were whether a treatment was a medication or surgery and out-of-pocket cost. Patients had statistically significant preferences for efficacy attributes related to symptom management and laboratory values, but placed less importance on the attributes related to mode of administration and side effects. The most bothersome attribute of surgery was the risk of surgical mortality. Conclusions Patients with ESRD and SHPT who are undergoing hemodialysis understand SHPT and have clear and measurable treatment preferences. These results may help inform clinicians about patients’ preferences regarding treatment options for a common complication of ESRD. |
topic |
Secondary hyperparathyroidism End-stage renal disease Discrete-choice experiment Conjoint analysis |
url |
http://link.springer.com/article/10.1186/s12882-017-0665-8 |
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