A Multiple Stakeholder Multicriteria Decision Analysis in Diabetic Macular Edema Management: The MULTIDEX-EMD Study

التفاصيل البيبلوغرافية
العنوان: A Multiple Stakeholder Multicriteria Decision Analysis in Diabetic Macular Edema Management: The MULTIDEX-EMD Study
المؤلفون: Gemma Peralta, Jacinto Zulueta, José Luis Poveda, Fernando de Andrés-Nogales, Emilio Ignacio, E. Cervera, Javier Zarranz-Ventura, Alfredo García-Layana, José M. Ruiz-Moreno, José Luis Trillo, Eloísa Álvarez, Carlos Mur, José Manuel Martínez-Sesmero, Pere Ortiz, Mariano Rodríguez-Maqueda, Mercedes Martínez, Iñaki Llorente, Miguel A. Casado, Patricia Udaondo, José Martínez-Olmos
المساهمون: Enfermería y Fisioterapia
المصدر: PharmacoEconomics Open
Pharmacoeconomics-Open
r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe
instname
PHARMACOECONOMICS-OPEN
RODIN. Repositorio de Objetos de Docencia e Investigación de la Universidad de Cádiz
بيانات النشر: Springer International Publishing, 2020.
سنة النشر: 2020
مصطلحات موضوعية: Multicriteria decision, Edema macular diabètic, medicine.medical_specialty, Visual acuity, MULTIDEX‑EMD study, Diabetic macular edema, MEDLINE, Retina, Patient safety, Quality of life, Internal medicine, IMPLEMENTATION, Medicine, Pharmacology (medical), Original Research Article, Multiple stakeholder, Pharmacology, Health management system, business.industry, Health Policy, MCDA, Multiple-criteria decision analysis, HEALTH-CARE, CHOICE EXPERIMENTS, medicine.symptom, business, Diabetic macular edema management, Ulls--Malalties, INTERVENTIONS
الوصف: Background: The clinical and economic management of retinal diseases has become more complex following the introduction of new intravitreal treatments. Multicriteria decision analysis (MCDA) offers the potential to overcome the challenges associated with traditional decision-making tools. Objectives: A MCDA to determine the most relevant criteria to decision-making in the management of diabetic macular edema (DME) based on the perspectives of multiple stakeholders in Spain was developed. This MCDA was termed the MULTIDEX-EMD study. Methods: Nineteen stakeholders (7 physicians, 4 pharmacists, 5 health authorities and health management experts, 1 psychologist, and 2 patient representatives) participated in this three-phase project. In phase A, an advisory board defined all of the criteria that could influence DME treatment decision-making. These criteria were then screened using a discrete choice experiment (DCE) (phase B). Next, a multinomial logit model was fitted by applying the backward elimination algorithm (relevant criteria: p value < 0.05). Finally, the results were discussed in a deliberative process (phase C). Results: Thirty-one criteria were initially defined (phase A) and grouped into 5 categories: efficacy/effectiveness, safety, organizational and economic impact, patient-reported outcomes, and other therapeutic features. The DCE results (phase B) showed that 10 criteria were relevant to the decision-making process for a 50- to 65-year-old DME patient: mean change in best corrected visual acuity (p value < 0.001), percentage of patients with an improvement of ≥ 15 letters (p value < 0.001), effect duration per administration (p value = 0.008), retinal detachment (p value < 0.001), endophthalmitis (p value = 0.012), myocardial infarction (p value < 0.001), intravitreal hemorrhage (p value = 0.021), annual treatment cost per patient (p value = 0.001), health-related quality of life (HRQoL) (p value = 0.004), and disability level (p value = 0.021). Conclusions: From a multi-stakeholder perspective, the selection of an appropriate treatment for DME patients should guarantee patient safety and maximize the visual acuity improvement and treatment effect duration. It should also contribute to system sustainability by being affordable, it should have a positive impact on HRQoL, and it should prevent disability.
وصف الملف: application/pdf
اللغة: English
تدمد: 2509-4254
2509-4262
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4d41a295125578df2e26463d59e122bc
http://europepmc.org/articles/PMC7688881
Rights: OPEN
رقم الانضمام: edsair.doi.dedup.....4d41a295125578df2e26463d59e122bc
قاعدة البيانات: OpenAIRE