While patients with Type 2 diabetes believe glucose control is important, medication side effects and risks influence patients' treatment choices. Medication-related weight gain and cardiovascular risk are significant predictors of likely medication non-adherence.

No abstract

Patients ranked ambulatory pain as a more important benefit than resting pain; likely due to its impact on ability to do daily activities. For a 25-mm reduction, patients were willing to accept four times the risk of MI in ambulatory pain vs resting pain.

BackgroundUp to a fifth of patients diagnosed with prostate cancer (PC) will develop castration-resistant prostate cancer (CRPC), which has been associated with a poor prognosis. The aim of this study was to consider the patient perspective as part of the overall treatment decision-making process for CRPC, given that an alignment between patient preference and prescribing has been shown to benefit patient outcomes. This study examines preferences of patients with CRPC in Japan for treatment features associated with treatments like RA-223, abiraterone, and docetaxel and to examine the extent to which treatment preferences may vary between symptomatic and asymptomatic patients.MethodsA two-phase research approach was implemented. In Phase 1, N = 8 patients with CRPC were recruited from a single hospital to complete a qualitative interview to provide feedback on the draft survey. In Phase 2, N = 134 patients with CRPC were recruited from five hospitals to complete a paper survey. The survey included 6 treatment choice questions, each asking patients to choose between two hypothetical treatments for their CRPC. Each treatment alternative was defined by the following attributes: length of overall survival (OS), time to a symptomatic skeletal event (SSE), method of administration, reduction in the risk of bone pain, treatment-associated risk of fatigue and lost work days. A hierarchical Bayesian logistic regression was used to estimate relative preference weights for each attribute level and mean relative importance.ResultsA total of N = 133 patients with CRPC completed the survey and were included in the final analysis. Patients had a mean age of 75.4 years (SD = 7.4) and had been diagnosed with PC a mean of 6.5 years prior (SD = 4.4). Over the attribute levels shown, fatigue (relative importance [RI] = 24.9 %, 95 % CI: 24.7 %, 25.1 %) was the most important attribute, followed by reduction in the risk of bone pain (RI = 23.2 %, 95 % CI: 23.0 %, 23.5 %), and OS (RI = 19.2 %, 95 % CI: 19.0 %, 19.4 %). Although symptomatic patients placed significantly more importance on delaying an SSE (p < .05), no other preference differences were observed.ConclusionsCRPC patients were more concerned about reduced quality of life from side effects of treatment rather than extension of survival, which may have implications for shared decision-making between patients and physicians.

Purpose Recent policies specifying criteria about which individual research results (IRRs) to return leave considerable discretion to researchers. This study investigated which types of results the public wants when participating in genetic research and whether preferences differ based on willingness to participate. Methods A representative survey of U.S. adults used conjoint analysis to measure priorities among eight principles of a results policy for a proposed large-cohort study. Policy preferences were measured using twelve tasks where respondents chose between two groupings of the policy principles. Stratified analysis compared those self-identified as likely or unlikely to participate in genomic research. Results Of 1,515 respondents, 56% would participate in the proposed study. All eight principles were positively endorsed by participants (all p<0.003) with priority placed on providing results at no cost, and returning well-validated results for treatable and serious diseases. Providing detailed result reports was more highly valued than providing staff to explain results (p=0.0005). Receiving results about major changes in risk was marginally disvalued by those unlikely to participate (p=0.35). Conclusion Public preferences for well-validated IRRs for serious, actionable diseases agree with emerging recommendations. However, since preferences for receiving IRRs vary, some choices should be offered to research participants.