[Objective Criteria in the Medicinal Therapy for Type II Diabetes: An Analysis of the Patients' Perspective with Analytic Hierarchy Process and Best-Worst Scaling]. / Zielkriterien der medikamentösen Therapie des Diabetes Typ II: Eine Analyse der Patientenperspektive mit Analytic Hierarchy Process und Best-Worst Scaling.

ABSTRACT

BACKGROUND: The patient's perspective with regard to decision criteria of alternative treatment options has hardly been analysed. The objective of any intervention in health-care is to increase the patient's benefit. OBJECTIVE: This study aimed to analyse the patient-relevant decision criteria in the medicinal therapy of type II diabetes. The characteristics of a drug therapy that are relevant for the choice of the patients should be revealed. METHOD: An explorative qualitative study (N=15) in combination with a quantitative survey (in total N=388) using Analytic Hierarchy Process and Best-Worst Scaling aimed at the determination of the importance of patient-relevant decision criteria. RESULTS: The quantitative AHP- and BWS survey resulted in a clear dominance of the attribute "HbA1c level" and its optimal settings, for both with oral anti-diabetics treated patients (OAD) and insulin-treated patients. In the group of the OAD patients both methods independently showed the same ranking of the following 3 ranks "delay of insulin therapy" (rank 2), "occurrence of hypoglycaemia" (rank 3) and "weight changes" (rank 4). For insulin patients "the occurrence of hypoglycaemia" follows in the AHP on the second rank and in the BWS on the 3(rd) rank. Compared to OAD patients, the relevance of the target criterion "weight changes" decreases in the group of the insulin patients in the AHP on the last rank (rank 7) and in the BWS on the second last rank (rank 6). CONCLUSION: For the first time the methods of AHP and BWS were combined to assess how patients weight between different characteristics of the treatment in type II diabetes and which influence those criteria of therapy have on the patient's benefit. Both patient groups show differences in the horizon of experience and thus in the ranking of the decision criteria.