BACKGROUND Little is known about how patients make decisions about and prioritize, therapies and disease management in eosinophilic esophagitis (EoE). We aimed to systematically identify and characterize patient perspectives and attitudes that influence decision making for EoE management. METHODS To understand the diverse attitudes and values of EoE patients, we designed a study using the Q-method. We iteratively developed 31 statements related to EoE disease management. Participants sorted statements by ranking from +4 (most agree) to -4 (most disagree). By-person factor analysis, using 2- and 3- factor rotation, revealed distinct preference archetypes. RESULTS Thirty-four adults with EoE (mean age 40.9, 51.4% male, 82.9% White) were recruited from gastroenterology and allergy clinics from a single center. We identified two treatment-centered archetypes: Medication preference, driven by symptoms and the desire to minimize risk of complications, and Natural treatment preference, focusing on identifying trigger foods and diet adherence. Three-factor analysis revealed an additional archetype: Treatment ambivalent, a view of EoE as a mild and episodic (not chronic) disease with low priority to treat. Comparison by factor revealed 54% of those in the natural preference archetype were recategorized as treatment ambivalent, suggesting that they see natural treatment as a less complicated or milder strategy and may be at risk of nonadherence and reduced treatment uptake. CONCLUSIONS We identified three distinct treatment preference archetypes among individuals with EoE, underscoring the need for personalized treatment strategies, especially for those favoring natural approaches but masking ambivalence, and may be at risk for nonadherence or loss to follow-up.

中文翻译：

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嗜酸性粒细胞性食管炎的治疗偏好原型及其对治疗的影响。


背景 关于嗜酸性粒细胞性食管炎 （EoE） 患者如何做出决策和优先考虑治疗和疾病管理知之甚少。我们旨在系统地识别和描述影响 EoO 管理决策的患者观点和态度。方法 为了了解 EoO 患者的不同态度和价值观，我们设计了一项使用 Q 方法的研究。我们迭代开发了 31 个与 EoO 疾病管理相关的陈述。参与者按从 +4（最同意）到 -4（最不同意）的排名对陈述进行排序。使用 2 因子和 3 因子轮换的按人因子分析揭示了不同的偏好原型。结果 34 名患有 EoO 的成年人 （平均年龄 40.9,51.4% 男性，82.9% 白人） 是从单个中心的胃肠病学和过敏诊所招募的。我们确定了两种以治疗为中心的原型：药物偏好，由症状和最小化并发症风险的愿望驱动，以及自然治疗偏好，侧重于识别触发食物和饮食依从性。三因素分析揭示了另一种原型：治疗矛盾，将 EoO 视为一种轻度和发作性（非慢性）疾病，治疗优先级较低。按因素比较显示，自然偏好原型中 54% 的人被重新归类为治疗矛盾，这表明他们将自然治疗视为一种不太复杂或更温和的策略，并且可能存在不依从和治疗接受率降低的风险。结论 我们在 EoO 个体中确定了三种不同的治疗偏好原型，强调了个性化治疗策略的必要性，特别是对于那些喜欢自然方法但掩盖矛盾心理的人，并且可能有不依从或失访的风险。