Who Can Respond to Treatment

Identifying Patient Characteristics Related to Heterogeneity of Treatment Effects

Dados Bibliográficos

ID9105055
AutoresSherrie H Kaplan (0000-0002-8644-5849, University of California, Irvine), John Billimek (0000-0001-6532-3263, University of California, Irvine), Dara H Sorkin (0000-0003-0742-9240, University of California, Irvine), Quyen Ngo‐Metzger (University of California, Irvine), Quyen Ngo-Metzger, Sheldon Greenfield (0000-0003-4628-1998, University of California, Irvine)
Ano2010
Volume48
Fascículo6
PáginasS9-S16
Data de publicação2010-06-01
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoMedical Care (JOURNAL)
Identificadores do periódicoISSN: 0025-7079 • E-ISSN: 1537-1948
EditoraOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e3181d99161
PMID20473205
OpenAlexW2028223895
IdiomaEN
Citações recebidas8
Referências citadas49

BACKGROUND: Interest in comparative effectiveness research and the rising number of negative or "small effect" trials have stimulated research into differential response to treatment among subgroups of patients. OBJECTIVE: To develop and test the Potential for Benefit Scale (PBS), a composite measure to identify subgroups of patients with differential potential for response to treatment, using diabetes as a model. DESIGN: Cross-sectional and longitudinal cohort study. SUBJECTS AND SETTING: Type 2 diabetes patients (n = 1361) were identified from 7 outpatient clinics serving a diverse population. Of these, 611 completed a 1-year follow-up. MEASURES: To represent patients' health status, we used the Total Illness Burden Index, the Physical Function Index of the SF-36, the Center for Epidemiologic Studies Depression Scale, and the Diabetes Burden Scale. To represent personality characteristics related to health, we used the Provider-Dependent Health Care Orientation scale. We assessed the contribution of these measures to a composite scale of patients' potential for treatment response in terms of self-reported medication adherence and glycemic control. RESULTS: Principal components analysis confirmed associations among these measures. The internal consistency reliability of the PBS was adequate (Cronbach alpha = 0.65). Patients in the lowest versus highest quartile of the PBS reported poorer adherence (18% vs. 55%, P < 0.001) and poorer glycemic control at baseline (mean hemoglobin A1c values: 7.75 vs. 7.39, P < 0.001). Those in the highest quartile of the PBS also were more likely to reach target values for glycemic control (HbA1c <7%) at 1-year follow-up, (adjusted OR = 1.61, P < 0.05). CONCLUSIONS: The PBS, a composite scale, may be helpful in identifying patients with differential potential for response to treatment

Cohort · Cronbach's alpha · Diabetes mellitus · Environmental health · Glycemic · Insulin · Physical therapy · Population · Psychometrics · Quartile · Clinical Psychology · Diabetes Management and Education · Internal Medicine · Medication Adherence and Compliance · Medicine · Mental Health and Patient Involvement