使用离散选择实验开发决策辅助工具以告知药房中持续性疼痛的管理：一项随机可行性研究方案。

Using a discrete choice experiment to develop a decision aid tool to inform the management of persistent pain in pharmacy: a protocol for a randomised feasibility study.

机构信息

Health Economics Research Unit, University of Aberdeen, Aberdeen, UK

Health Economics Research Unit, University of Aberdeen, Aberdeen, UK.

出版信息

BMJ Open. 2022 Sep 22;12(9):e066379. doi: 10.1136/bmjopen-2022-066379.

DOI:10.1136/bmjopen-2022-066379

PMID:36137622

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9511577/

Abstract

INTRODUCTION

In an era of personalised healthcare, it has become increasingly important to elicit individual-level preferences. While discrete choice experiments (DCEs) are widely used to measure patient preferences in the delivery of healthcare, the focus has been sample-level analysis. Using the DCE methodology, this project has designed a digital decision aid tool (DAT) with the potential to estimate individual preferences in real time to inform clinical consultation decisions in persistent pain management.

METHODS

Using a feasibility randomised control trial, this study aims to assess the feasibility of using this Understanding Persistent Pain (UPP) DAT in a pharmacy-based clinical setting and to test processes for a future definite randomised trial. Community and practice-based pharmacists (up to 10) will be recruited in The National Health Service (NHS) Grampian and trained in the use of the digital UPP DAT. Pharmacists will recruit up to 60 patients who are living with persistent pain. Patients will be randomised to one of two groups: using the UPP DAT or usual care. Pharmacists will follow-up patients as needed according to clinical need and following standard practice. DCE response data collected by the UPP DAT will be analysed using the penalised logit model, allowing estimation of individual preferences in real time. We will follow-up pharmacists and patients who use the UPP DAT to gather feedback on their experiences.

ETHICS AND DISSEMINATION

This study received ethical approval from the North of Scotland Research Ethics Committee (21/NS/0059) and received Research & Development Management Permission to proceed from NHS Grampian (2021UA003E). The study has been registered in the ClinicalTrials.gov database. Findings will be disseminated in peer-reviewed publications, presentations and newsletters and made available in the University of Aberdeen and Pharmacy Research UK websites. Participants gave informed consent to participate in the study before taking part.

TRIAL REGISTRATION NUMBER

NCT05102578; clinicaltrials.gov.

摘要

简介

在个性化医疗保健时代，越来越重要的是要引出个人层面的偏好。虽然离散选择实验（DCE）被广泛用于衡量医疗保健提供中的患者偏好，但重点一直是样本层面的分析。本项目使用 DCE 方法学设计了一种数字决策辅助工具（DAT），具有实时估计个体偏好的潜力，以告知持续性疼痛管理中的临床咨询决策。

方法

本研究采用可行性随机对照试验，旨在评估在基于社区的药剂师临床环境中使用这种理解持续性疼痛（UPP）DAT 的可行性，并测试未来确定性随机试验的流程。将在英国国民健康服务（NHS）格兰扁招募多达 10 名社区和实践型药剂师，并对他们进行数字 UPP DAT 使用方面的培训。药剂师将招募多达 60 名患有持续性疼痛的患者。患者将随机分为两组：使用 UPP DAT 或常规护理。药剂师将根据临床需要和标准实践，根据需要对患者进行随访。UPP DAT 收集的 DCE 响应数据将使用惩罚对数模型进行分析，允许实时估计个体偏好。我们将随访使用 UPP DAT 的药剂师和患者，以收集他们的反馈。

伦理和传播

本研究获得了北苏格兰研究伦理委员会（21/NS/0059）的伦理批准，并获得了 NHS Grampian 的研究与开发管理许可（2021UA003E）。该研究已在 ClinicalTrials.gov 数据库中注册。研究结果将发表在同行评议的出版物、演讲和通讯中，并在阿伯丁大学和英国药房研究网站上提供。参与者在参与研究之前已给予知情同意。