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Sun Q, Wang Y, Wang P, Huang Y, Xi X. Residents Preferences for Pharmacist-Managed Clinic in China: A Discrete Choice Experiment. Patient Prefer Adherence 2024; 18:1409-1422. [PMID: 38978750 PMCID: PMC11228533 DOI: 10.2147/ppa.s457655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 06/14/2024] [Indexed: 07/10/2024] Open
Abstract
Purpose This study aimed to survey and analyze the preferences for pharmacist-managed clinic among urban residents in China. Materials and Methods A discrete choice experiment was conducted in Nanjing, China. A D-efficient fractional factorial design was used to generate the questionnaire. Three models were used to investigate each patient's strength of preference and preference heterogeneity. The relative importance for each treatment attribute was also determined. Results 156 usable questionnaires (of 228 questionnaires sent out) were received. Respondents preferred pharmacist-managed clinics with the following characteristics: good pharmacists' knowledge and clinical medication practice competency, lower consultation fees, a dedicated consultation room, physician-pharmacist joint clinic, with pharmacists' knowledge competency receiving the highest priority. Latent class analysis revealed three classes (Experiential Type, Content Type and Economic Type) were identified based on respondents' preferences for pharmacist-managed clinics. Conclusion The respondents were willing to choose a PMC relative to the current situation. When deciding on a pharmacist-managed clinic, residents are driven by pharmacists' competency, consultation fee, availability of consultation rooms and collaborative care or independent pharmacist service. Differences in patients' preferences identified in the study provide information on pharmacist-managed clinics that meet residents' expectations.
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Affiliation(s)
- Qingran Sun
- National Medical Products Administration Key Laboratory for Drug Regulatory Innovation and Evaluation, China Pharmaceutical University, Nanjing, Jiangsu Province, People’s Republic of China
| | - Yi Wang
- National Medical Products Administration Key Laboratory for Drug Regulatory Innovation and Evaluation, China Pharmaceutical University, Nanjing, Jiangsu Province, People’s Republic of China
| | - Pei Wang
- National Medical Products Administration Key Laboratory for Drug Regulatory Innovation and Evaluation, China Pharmaceutical University, Nanjing, Jiangsu Province, People’s Republic of China
| | - Yuankai Huang
- National Medical Products Administration Key Laboratory for Drug Regulatory Innovation and Evaluation, China Pharmaceutical University, Nanjing, Jiangsu Province, People’s Republic of China
| | - Xiaoyu Xi
- National Medical Products Administration Key Laboratory for Drug Regulatory Innovation and Evaluation, China Pharmaceutical University, Nanjing, Jiangsu Province, People’s Republic of China
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Riboulet M, Clairet AL, Bennani M, Nerich V. Patient Preferences for Pharmacy Services: A Systematic Review of Studies Based on Discrete Choice Experiments. THE PATIENT 2024; 17:13-24. [PMID: 38093090 DOI: 10.1007/s40271-023-00652-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND AND OBJECTIVE In recent years, the mission of pharmacists has evolved and the model of the caregiver-patient relationship has been challenged by a new patient-centered approach. A challenge to providing personalized care is the assessment of patient preferences. We aimed to systematically identify published discrete choice experiments related to patient preferences for pharmacy services and to assess the quality of the selected articles. METHODS A systematic review of the literature was conducted in two databases (PubMed and Embase, until March 2023) according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The quality of the selected articles was assessed according to the International Society for Pharmacoeconomics and Outcomes Research conjoint analysis checklist. RESULTS Among the 421 articles identified, 16 published studies were included and analyzed. They were mostly published in pharmaceutical (n = 6), economic (n = 4), and public health (n = 4) journals. Only two articles concerned the field of hospital pharmacy. Only five presented the specific pharmacy service studied: filling of prescriptions, management of symptoms, treatment delivery, and components of pharmacist counseling. Five articles focused on pharmacy services related to a specific disease. None fully fulfilled the International Society for Pharmacoeconomics and Outcomes Research checklist, only partially fulfilled. CONCLUSIONS According to the identified studies, cost, time, logistics (organizational criteria), and pharmacists' courtesy and skills were consistently cited as factors influencing patient preferences for pharmacy services. The disclosure of patient preferences is a complex and under-researched topic, especially in the field of pharmacy, but interest is growing. As the mission of pharmacists evolves to bring them closer to patients, the better understanding of patient preferences in pharmacy services will allow for better targeting and better integration of patient profiles in patient management.
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Affiliation(s)
| | - Anne-Laure Clairet
- Université de Franche-Comté, CHU Besançon, INSERM, EFS BFC, UMR1098, RIGHT, Pôle Pharmacie, F-25030, Besançon Cedex, France
| | | | - Virginie Nerich
- Université de Franche-Comté, CHU Besançon, INSERM, EFS BFC, UMR1098, RIGHT, Pôle Pharmacie, F-25030, Besançon Cedex, France.
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Zhuge J, Zheng D, Li X, Nie X, Liu J, Liu R. Parental preferences for the procedural sedation of children in dentistry: a discrete choice experiment. Front Pediatr 2023; 11:1132413. [PMID: 38116578 PMCID: PMC10728602 DOI: 10.3389/fped.2023.1132413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 11/16/2023] [Indexed: 12/21/2023] Open
Abstract
Purpose The aim of this study was to explore parental preferences for the procedural sedation of children in dentistry through a discrete choice experiment (DCE) to inform clinical decisions and oral health management. Methods Based on literature reviews, interviews with parents of pediatric dental patients, and expert consultation, six attributes, including fasting time, recovery time, sedative administration routes, adverse reactions, sedation depth and procedure cost, were incorporated into the DCE questionnaire. The DCE questionnaire collected data on parental preferences for pediatric dental sedation treatment from June to August 2022. A conditional logit model was used to analyze preference and willingness to pay (WTP) for each attribute and its level. Subgroup analyses assessing the impact of parents' dental anxiety on procedural sedation preferences were also conducted using conditional logit models. Results A total of 186 valid questionnaires were gathered. Parents' preferences for fewer adverse reactions, a milder sedation depth, lower out-of-pocket cost, shorter fasting and recovery times and administration by inhalation were significantly associated with their choice of sedation model. The conditional logit model showed that parents were most interested in treatments with no adverse reactions (0% vs. 15%) (Coef, 1.033; 95% CI, 0.833-1.233), followed by those providing minimal sedation (vs. deep sedation) (Coef, 0.609; 95% CI, 0.448-0.769). Moreover, the relative importance of adverse reactions and fasting time was higher among anxious than nonanxious parents. The study found a WTP threshold of ¥1,538 for reducing adverse reactions (15% to 0%). The WTP threshold for the best sedation procedure scenario (no fasting requirement, 10 min recovery time, administration by inhalation, 0% adverse reaction incidence and minimal sedation) was ¥3,830. Conclusion Reducing the adverse reactions and depth of sedation are predominant considerations for parents regarding procedural sedation in pediatric dentistry, followed by lower cost, shorter fasting and recovery times and inhalation sedation. Parents with dental anxiety had a stronger preference for options with a lower incidence of adverse reactions and shorter fasting time than parents without dental anxiety. This discovery is helpful for doctors and can promote collaborative decision-making among parents and doctors.
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Affiliation(s)
- Jinru Zhuge
- Department of Anesthesiology, The Affiliated Stomatology Hospital of Wenzhou Medical University, Wenzhou, China
| | - Dongyue Zheng
- Department of Nursing, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xingwang Li
- Department of Anesthesiology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xin Nie
- Department of Stomatology, The Affiliated Stomatology Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jiefan Liu
- Department of Stomatology, The Affiliated Stomatology Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ruohai Liu
- Department of Anesthesiology, The Affiliated Stomatology Hospital of Wenzhou Medical University, Wenzhou, China
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Couples' Preferences for "2 in 1" Multipurpose Prevention Technologies to Prevent Both HIV and Pregnancy: Results of a Discrete Choice Experiment in Uganda and Zimbabwe. AIDS Behav 2022; 26:3848-3861. [PMID: 35674885 PMCID: PMC9175528 DOI: 10.1007/s10461-022-03713-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
End-user input early in biomedical product development may optimize design to support high uptake and adherence. We interviewed 400 couples (800 total participants) in Uganda and Zimbabwe to assess their preferences for multipurpose prevention technologies (MPTs) for HIV and pregnancy prevention. Using a discrete choice experiment, couples made a series of choices between hypothetical MPTs, including oral tablets and vaginal rings, inserts, and films and completed an interviewer-administered questionnaire assessing sociodemographic and behavioral measures. Most couples preferred presented MPTs over male condoms. Couples’ MPT choices in both countries were influenced most by the combination of product form and dosing frequency, with monthly dosing preferred over daily. Analysis highlighted differences by country as to which side effects were most important: Ugandan couples placed greater importance on effects on the vaginal environment during sex, whereas Zimbabwean couples placed more importance on changes to menstruation and other side effects (headache, cramps). Couples’ preferences signaled an openness to new product forms and more frequent dosing if preferred characteristics of other attributes were achieved.
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Lv Y, Ren R, Tang C, Song K, Li S, Wang H. Preferences for Patients with Type 2 Diabetes Mellitus for Medications in Shandong Province, China: A Discrete Choice Experiment. Patient Prefer Adherence 2022; 16:2335-2344. [PMID: 36046499 PMCID: PMC9423121 DOI: 10.2147/ppa.s367985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/10/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To evaluate preferences for medications among patients with type 2 diabetes mellitus (T2DM) from urban community health stations or rural village clinics in Shandong province, China. METHODS We use a discrete choice experiment (DCE) to measure the medication preferences. Each patient completed six DCE choice sets. The attributes for the DCE questionnaire include mode of administration, out-of-pocket medication cost per month, fasting blood glucose control effect and frequency of hypoglycemia events. The conditional logit model (Clogit) and mixed logit model (MXL) were used to evaluate choice data. RESULTS A total of 887 patients with T2DM completed the survey. The mean age of participants was 64 years, 36.42% experienced complications, and the mean duration of diabetes was about 8 years. Overall, patients' ideal medication would not have hypoglycemia events, provide normal fasting glucose levels, have oral medication three times a day and lower monthly medication cost. Patients prioritized the frequency of hypoglycemia events (β=15.055, P < 0.01) and were willing to spend CNY 393.10 per month to avoid hypoglycemia events. For patients with higher educational levels and with longer diagnosis time, the effect of fasting blood glucose was more relevant than all other outcomes. CONCLUSION This study provides information on T2DM patients' preference for medications. Our results suggest that clinical doctors should present patients with a variety of pharmaceutical characteristics and include their preference into medication decision, which will improve patient adherence and health outcomes.
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Affiliation(s)
- Yuyu Lv
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, People’s Republic of China
| | - Ru Ren
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, People’s Republic of China
- Center for Health Preference Research, Shandong University, Jinan, People’s Republic of China
| | - Chengxiang Tang
- Macquarie University Centre for the Health Economy, Macquarie University Business School & Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Kuimeng Song
- School of Health Care Security, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, People’s Republic of China
| | - Shunping Li
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, People’s Republic of China
- Center for Health Preference Research, Shandong University, Jinan, People’s Republic of China
- Correspondence: Shunping Li; Haipeng Wang, Centre for Health Management and Policy Research, Wenhua Xi Road 44, Jinan, Shandong Province, 250012, People’s Republic of China, Tel +86-131-8893-4998, +86-186-6899-6362, Email ;
| | - Haipeng Wang
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, People’s Republic of China
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Raghunandan R, Howard K, Marra CA, Tordoff J, Smith A. Identifying New Zealand Public Preferences for Pharmacist Prescribers in Primary Care: A Discrete Choice Experiment. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2021; 15:77-92. [PMID: 34109570 DOI: 10.1007/s40271-021-00529-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/18/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE Given increasing patient populations, general practitioner workforce constraints and the growing demand for health services in New Zealand (NZ), the development and provision of pharmacist prescribing services could be used to improve people's access to medicines. A discrete choice experiment (DCE) was utilised to determine NZ public preferences for pharmacist prescribing services in primary care in NZ. METHODS A D-efficient DCE design generated 20 choice questions in four blocks of five questions with three labelled alternatives per choice question. The online DCE used a NZ general public online research panel administered by an external organisation (SurveyEngine). The DCE included six attributes with two attributes each with two levels (location of consultation and consultation type), three levels (type of service and operating hours) and four levels (waiting time and cost). RESULTS Nine hundred and twenty-four respondents completed the survey with 4620 observations available for analyses. Respondents preferred pharmacist prescribing services with the following characteristics: optimisation of medicines and changes to only current medicine service types (relative to repeat prescribing); lower consultation costs, shorter waiting times, longer operating hours and consultation by appointment (relative to walk-in and wait clinic). CONCLUSIONS Prescribing policy could incorporate these public preferences to help develop accessible and effective primary care prescribing services utilising the skills of pharmacist prescribers to improve and reduce inequities in access to medicines in NZ. These results suggest the NZ public see pharmacists as part of the primary care prescribing team and are willing to utilise them if these services are implemented.
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Affiliation(s)
- Rakhee Raghunandan
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, Otago, 9054, New Zealand.
| | - Kirsten Howard
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Carlo A Marra
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, Otago, 9054, New Zealand
| | - June Tordoff
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, Otago, 9054, New Zealand
| | - Alesha Smith
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, Otago, 9054, New Zealand
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Raghunandan R, Howard K, Marra CA, Tordoff J, Smith A. Identifying Community Pharmacist Preferences For Prescribing Services in Primary Care in New Zealand: A Discrete Choice Experiment. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2021; 19:253-266. [PMID: 33073328 DOI: 10.1007/s40258-020-00615-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/30/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Given increasing patient populations, general practitioner (GP) workforce constraints and increasing demand for health services in New Zealand (NZ), the development and provision of pharmacist prescribing services may need to increase to improve people's access to medicines. A discrete choice experiment (DCE) was utilised to determine community pharmacist preferences for prescribing services in primary care in NZ, and to understand how these factors could improve the provision of pharmacist prescribing services. METHODS A D-efficient design generated 30 labelled choice questions in three blocks of ten, and three alternatives per choice question. The online DCE was emailed to practising community pharmacists in NZ. The DCE included two attributes with five levels (prescribing model, educational requirements) and three attributes with three levels (location, professional fee, change in income). A mixed multinomial logit model was used to estimate preferences. RESULTS A total of 264 respondents completed the survey with 2640 observations for analyses. This DCE found pharmacists preferred pharmacy services with the following characteristics: ability to prescribe using minor ailments and independent prescribing models relative to the pharmacist-only medicines prescribing model; prescribing education by accredited learning modules relative to PGDipClinPharm + PGCertPharmPres; remuneration via a professional fee; and pharmacist prescribing services located in community pharmacies rather than in GP practices. CONCLUSIONS Prescribing policy could incorporate these pharmacist preferences to help develop accessible and effective pharmacist prescribing services that not only improve access to medicines, but also address inequity of access to medicines in NZ. These DCE results are encouraging as they signal that the community pharmacists also see themselves and their pharmacies as part of the prescribing team in primary care in NZ.
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Affiliation(s)
- Rakhee Raghunandan
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, 9054, Otago, New Zealand.
| | - Kirsten Howard
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Carlo A Marra
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, 9054, Otago, New Zealand
| | - June Tordoff
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, 9054, Otago, New Zealand
| | - Alesha Smith
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, 9054, Otago, New Zealand
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Pearce A, Harrison M, Watson V, Street DJ, Howard K, Bansback N, Bryan S. Respondent Understanding in Discrete Choice Experiments: A Scoping Review. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2020; 14:17-53. [PMID: 33141359 PMCID: PMC7794102 DOI: 10.1007/s40271-020-00467-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/30/2020] [Indexed: 11/27/2022]
Abstract
Introduction Despite the recognised importance of participant understanding for valid and reliable discrete choice experiment (DCE) results, there has been limited assessment of whether, and how, people understand DCEs, and how ‘understanding’ is conceptualised in DCEs applied to a health context. Objectives Our aim was to identify how participant understanding is conceptualised in the DCE literature in a health context. Our research questions addressed how participant understanding is defined, measured, and used. Methods Searches were conducted (June 2019) in the MEDLINE, EMBASE, PsychINFO and Econlit databases, as well as hand searching. Search terms were based on previous DCE systematic reviews, with additional understanding keywords used in a proximity-based search strategy. Eligible studies were peer-reviewed journal articles in the field of health, related to DCE or best-worst scaling type 3 (BWS3) studies, and reporting some consideration or assessment of participant understanding. A descriptive analytical approach was used to chart relevant data from each study, including publication year, country, clinical area, subject group, sample size, study design, numbers of attributes, levels and choice sets, definition of understanding, how understanding was tested, results of the understanding tests, and how the information about understanding was used. Each study was categorised based on how understanding was conceptualised and used within the study. Results Of 306 potentially eligible articles identified, 31 were excluded based on titles and abstracts, and 200 were excluded on full-text review, resulting in 75 included studies. Three categories of study were identified: applied DCEs (n = 52), pretesting studies (n = 7) and studies of understanding (n = 16). Typically, understanding was defined in relation to either the choice context, such as attribute terminology, or the concept of choosing. Very few studies considered respondents’ engagement as a component of understanding. Understanding was measured primarily through qualitative pretesting, rationality or validity tests included in the survey, and participant self-report, however reporting and use of the results of these methods was inconsistent. Conclusions Those conducting or using health DCEs should carefully select, justify, and report the measurement and potential impact of participant understanding in their specific choice context. There remains scope for research into the different components of participant understanding, particularly related to engagement, the impact of participant understanding on DCE validity and reliability, the best measures of understanding, and methods to maximise participant understanding. Electronic supplementary material The online version of this article (10.1007/s40271-020-00467-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alison Pearce
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.
| | - Mark Harrison
- Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Verity Watson
- Health Economics Research Unit, University of Aberdeen, Aberdeen, Scotland
| | - Deborah J Street
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia
| | - Kirsten Howard
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Nick Bansback
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Stirling Bryan
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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Minnis AM, Atujuna M, Browne EN, Ndwayana S, Hartmann M, Sindelo S, Ngcwayi N, Boeri M, Mansfield C, Bekker L, Montgomery ET. Preferences for long-acting Pre-Exposure Prophylaxis (PrEP) for HIV prevention among South African youth: results of a discrete choice experiment. J Int AIDS Soc 2020; 23:e25528. [PMID: 32544303 PMCID: PMC7297460 DOI: 10.1002/jia2.25528] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 03/12/2020] [Accepted: 04/03/2020] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Existing biomedical HIV prevention options, though highly effective, present substantial adherence challenges. End-user input on early-stage design of new HIV prevention approaches is critical to yielding products that achieve high uptake and adherence. The iPrevent Study examined youths' preferences for key attributes of long-acting Pre-Exposure Prophylaxis (PrEP), with a focus on characteristics pertinent to product delivery alongside key modifiable product attributes. METHODS A discrete choice experiment was conducted with female and male youth aged 18 to 24 in two high-density communities in Cape Town, South Africa during the period July 2017 to January 2019. Sexually active, PrEP-naïve youth were recruited using population-based sampling; targeted sampling was used to enrol men who have sex with men (MSM). In a series of nine questions, participants were asked to choose between two hypothetical products composed of five attributes (form, dosing frequency, access, pain, insertion site). We used a random-parameters logit model to estimate preference weights and trade-offs among product alternatives. We examined differences across three subgroups: females, men who have sex with only women (MSW) and MSM. RESULTS A total of 807 participants (401 female) were enrolled with a median age of 21 years. Males included 190 MSM. Most youth had tested for HIV (95%) and reported being HIV-negative (91%). Across all groups, duration of effectiveness was the most important attribute, with strong preference for less frequent dosing. Injections were favoured over implants, though these preferences were strongest for females and MSM. Females preferred a product offered at a health clinic and disliked pharmacy access; all groups preferred the arm as the insertion site. Youth were willing to trade their preferred product form for longer duration. CONCLUSIONS Youth indicated strong preferences for longer duration products. Each attribute nonetheless influenced preferences, offering insight into trade-offs that inform long-acting PrEP development.
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Affiliation(s)
| | | | - Erica N Browne
- Women’s Global Health ImperativeRTI InternationalSan FranciscoCAUSA
| | - Sheily Ndwayana
- The Desmond Tutu HIV CentreUniversity of Cape TownSouth Africa
| | - Miriam Hartmann
- Women’s Global Health ImperativeRTI InternationalSan FranciscoCAUSA
| | | | | | - Marco Boeri
- Health Preference AssessmentRTI Health SolutionsBelfastIreland
| | - Carol Mansfield
- Health SolutionsRTI InternationalResearch Triangle ParkNCUSA
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Jiang MZ, Fu Q, Xiong JY, Li XL, Jia EP, Peng YY, Shen X. Preferences heterogeneity of health care utilization of community residents in China: a stated preference discrete choice experiment. BMC Health Serv Res 2020; 20:430. [PMID: 32423447 PMCID: PMC7236293 DOI: 10.1186/s12913-020-05134-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 03/20/2020] [Indexed: 11/27/2022] Open
Abstract
Background To tackle the issue with the low usage of primary healthcare service in China, it is essential to align resource distribution with the preferences of the community residents. There are few academic researches for describing residents’ perceived characteristics of healthcare services in China. This study aims to investigate the preferences of healthcare services utilization in community residents and explore the heterogeneity. The findings will be useful for the policy makers to take targeted measures to tailor the provision of healthcare services. Methods The face-to-face interviews and surveys were conducted to elicit four key attributes (care provider; mode of services; cost; travel time) of the preference from community residents for healthcare utilization. A rational test was presented first to confirm the consistency, and then 16 pairs of choice tasks with 12 sociodemographic items were given to the respondents. Two hypothetical options for each set, without an opt-out option, were presented in each choice task. The latent class analysis (LCA) was used to analyse the data. Results Two thousand one hundred sixty respondents from 36 communities in 6 cities were recruited for our study. 2019 (93.47%) respondents completed valid discrete choice experiment (DCE) questionnaires. The LCA results suggested that four groups of similar preferences were identified. The first group (27.29%) labelled as “Comprehensive consideration” had an even preference of all four attributes. The second group (37.79%) labelled as “Price-driven” preferred low-price healthcare services. The third group labelled as “Near distance” showed a clear preference for seeking healthcare services nearby. The fourth group (34.18%) labelled as “Quality seeker” preferred the healthcare service provided by experts. Willingness to pay (WTP) results showed that people were willing to accept CNY202.12($29.37) for Traditional Chinese Medicine (TCM) services and willing to pay CNY604.31($87.81) for the service provided by experts. Conclusions Our study qualitatively measures the distinct preferences for healthcare utilization in community residents in China. The results suggest that the care provider, mode of services, travel time and cost should be considered in priority setting decisions. The study, however, reveals substantial disagreement in opinion of TCM between different population subgroups.
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Affiliation(s)
- Ming-Zhu Jiang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Qiang Fu
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Ju-Yang Xiong
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
| | - Xiang-Lin Li
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Er-Ping Jia
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Ying-Ying Peng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Xiao Shen
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
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Robles LA, Wright SJ, Hackshaw-McGeagh L, Shingler E, Shiridzinomwa C, Lane JA, Martin RM, Burden S. Prostate cancer survivors' preferences on the delivery of diet and lifestyle advice: a pilot best-worst discrete choice experiment. Pilot Feasibility Stud 2020; 6:2. [PMID: 31921435 PMCID: PMC6945704 DOI: 10.1186/s40814-019-0549-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 12/23/2019] [Indexed: 02/07/2023] Open
Abstract
Background Lifestyle factors, including diet and physical activity, are associated with prostate cancer progression and mortality. However, it is unclear how men would like lifestyle information to be delivered following primary treatment. This study aimed to identify men’s preferences for receiving lifestyle information. Methods We conducted a cross-sectional pilot best-worst discrete choice experiment which was nested within a feasibility randomised controlled trial. Our aim was to explore men’s preferences of receiving diet and physical activity advice following surgery for localised prostate cancer. Thirty-eight men with a mean age of 65 years completed best-worst scenarios based on four attributes: (1) how information is provided; (2) where information is provided; (3) who provides information; and (4) the indirect cost of receiving information. Data was analysed using conditional logistic regression. Men’s willingness to pay (WTP) for aspects of the service was calculated using an out-of-pocket cost attribute. Results The combined best-worst analysis suggested that men preferred information through one-to-one discussion β = 1.07, CI = 0.88 to 1.26) and not by email (β = − 1.02, CI = − 1.23 to − 0.80). They preferred information provided by specialist nurses followed by dietitians (β = 0.76, CI = 0.63 to 0.90 and − 0.16, CI = − 0.27 to − 0.05 respectively) then general nurses (β = − 0.60, CI = − 0.73 to − 0.48). Three groups were identified based on their preferences. The largest group preferred information through individual face-to-face or group discussions (β = 1.35, CI = 1.05 to 1.63 and 0.70, CI = 0.38 to 1.03 respectively). The second group wanted information via one-to-one discussions or telephone calls (β = 1.89, CI = 1.41 to 2.37 and 1.03, CI = 0.58 to 1.48 respectively), and did not want information at community centres (β = − 0.50, CI = − 0.88 to − 0.13). The final group preferred individual face-to-face discussions (β = 0.45, CI = 0.03 to 0.88) but had a lower WTP value (£17). Conclusions Men mostly valued personalised methods of receiving diet and physical activity information over impersonal methods. The out-of-pocket value of receiving lifestyle information was important to some men. These findings could help inform future interventions using tailored dietary and physical activity advice given to men by clinicians following treatment for prostate cancer, such as mode of delivery, context, and person delivering the intervention. Future studies should consider using discrete choice experiments to examine information delivery to cancer survivor populations.
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Affiliation(s)
- Luke A Robles
- 1National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Level 3, University Hospitals Bristol Education Centre, Upper Maudlin Street, Bristol, BS2 8AE UK
| | - Stuart J Wright
- 2Manchester Centre for Health Economics, The University of Manchester, Manchester, M13 9PL UK.,3Manchester Academic Health Sciences Centre (MAHSC), Manchester, M13 9NT UK
| | - Lucy Hackshaw-McGeagh
- 1National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Level 3, University Hospitals Bristol Education Centre, Upper Maudlin Street, Bristol, BS2 8AE UK
| | - Ellie Shingler
- 1National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Level 3, University Hospitals Bristol Education Centre, Upper Maudlin Street, Bristol, BS2 8AE UK
| | - Constance Shiridzinomwa
- 4North Bristol NHS Trust, Southmead Hospital Bristol, Southmead Road, Westbury-on-Trym, Bristol, BS10 5NB UK
| | - J Athene Lane
- 1National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Level 3, University Hospitals Bristol Education Centre, Upper Maudlin Street, Bristol, BS2 8AE UK.,5Bristol Randomised Trials Collaboration, Bristol Medical School, Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS UK.,6Integrative Cancer Epidemiology Programme, Bristol Medical School, Population Health Sciences, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN UK
| | - Richard M Martin
- 1National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Level 3, University Hospitals Bristol Education Centre, Upper Maudlin Street, Bristol, BS2 8AE UK.,6Integrative Cancer Epidemiology Programme, Bristol Medical School, Population Health Sciences, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN UK
| | - Sorrel Burden
- 3Manchester Academic Health Sciences Centre (MAHSC), Manchester, M13 9NT UK.,7School of Health Sciences, Jean McFarlane Building, The University of Manchester, Manchester, M13 9PL UK.,8Salford Royal NHS Foundation Trust, Salford, M6 8HD UK
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12
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Young Women's Stated Preferences for Biomedical HIV Prevention: Results of a Discrete Choice Experiment in Kenya and South Africa. J Acquir Immune Defic Syndr 2019; 80:394-403. [PMID: 30633040 PMCID: PMC6410963 DOI: 10.1097/qai.0000000000001945] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Supplemental Digital Content is Available in the Text. Background: Integrating end-user perspectives into the design of new biomedical HIV prevention products is recognized as vital to informing the product development pipeline. Setting: Kisumu, Kenya; and Soshanguve, South Africa. Methods: We conducted a discrete choice experiment survey with 536 women aged 18–30 years to assess preferences for hypothetical HIV prevention products characterized by the attributes of efficacy, pregnancy prevention, delivery form, dosing frequency, and side effects. Participants included product-experienced women from Tablet, Ring, Injection as Options TRIO, a cross-over clinical study evaluating 3 placebo delivery forms (oral tablets, vaginal rings, and injections), and a product-naive sample recruited from the same communities. Analyses used random parameters logit and latent class models. Results: HIV prevention efficacy was a strong determinant of stated choice overall; however, in South Africa, delivery form was just as important, with an injection every 2–3 months most preferred and a daily oral tablet least preferred. In Kenya, product-experienced women preferred monthly injections and least preferred a monthly ring. Respondents indicated a preference for multipurpose prevention technologies that combine HIV and pregnancy protection. Latent class analyses confirmed these findings and delineated heterogeneity in preferences across subgroups defined by age, past experience with the delivery forms, and education. Conclusions: Despite an overall preference for products with high efficacy, we identified attributes salient to future uptake and use of HIV prevention products. Preferences for injectable products underscored interest in this pre-exposure prophylaxis delivery form. Likewise, the multipurpose prevention technology feature was valued in both Kenya and South Africa and most influenced interest in vaginal rings.
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13
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Accounting for Scale Heterogeneity in Healthcare-Related Discrete Choice Experiments when Comparing Stated Preferences: A Systematic Review. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2019; 11:475-488. [PMID: 29492903 DOI: 10.1007/s40271-018-0304-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Scale heterogeneity, or differences in the error variance of choices, may account for a significant amount of the observed variation in the results of discrete choice experiments (DCEs) when comparing preferences between different groups of respondents. OBJECTIVE The aim of this study was to identify if, and how, scale heterogeneity has been addressed in healthcare DCEs that compare the preferences of different groups. METHODS A systematic review identified all healthcare DCEs published between 1990 and February 2016. The full-text of each DCE was then screened to identify studies that compared preferences using data generated from multiple groups. Data were extracted and tabulated on year of publication, samples compared, tests for scale heterogeneity, and analytical methods to account for scale heterogeneity. Narrative analysis was used to describe if, and how, scale heterogeneity was accounted for when preferences were compared. RESULTS A total of 626 healthcare DCEs were identified. Of these 199 (32%) aimed to compare the preferences of different groups specified at the design stage, while 79 (13%) compared the preferences of groups identified at the analysis stage. Of the 278 included papers, 49 (18%) discussed potential scale issues, 18 (7%) used a formal method of analysis to account for scale between groups, and 2 (1%) accounted for scale differences between preference groups at the analysis stage. Scale heterogeneity was present in 65% (n = 13) of studies that tested for it. Analytical methods to test for scale heterogeneity included coefficient plots (n = 5, 2%), heteroscedastic conditional logit models (n = 6, 2%), Swait and Louviere tests (n = 4, 1%), generalised multinomial logit models (n = 5, 2%), and scale-adjusted latent class analysis (n = 2, 1%). CONCLUSIONS Scale heterogeneity is a prevalent issue in healthcare DCEs. Despite this, few published DCEs have discussed such issues, and fewer still have used formal methods to identify and account for the impact of scale heterogeneity. The use of formal methods to test for scale heterogeneity should be used, otherwise the results of DCEs potentially risk producing biased and potentially misleading conclusions regarding preferences for aspects of healthcare.
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14
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Wright SJ, Ulph F, Lavender T, Dharni N, Payne K. Understanding Midwives' Preferences for Providing Information About Newborn Bloodspot Screening. MDM Policy Pract 2018; 3:2381468317746170. [PMID: 30288434 PMCID: PMC6125045 DOI: 10.1177/2381468317746170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 10/05/2017] [Indexed: 11/30/2022] Open
Abstract
Background: Understanding preferences for information provision in
the context of health care service provision is challenging because of the
number of potential attributes that may influence preferences. This study aimed
to identify midwives’ preferences for the process and outcomes of information
provision in an expanded national newborn bloodspot screening program.
Design: A sample of practicing midwives completed a
hybrid-stated preference survey including a conjoint analysis (CA) and discrete
choice experiment to quantify preferences for the types of, and way in which,
information should be provided in a newborn bloodspot screening program. Six
conjoint analysis questions captured the impact of different types of
information on parents’ ability to make a decision, and 10 discrete choice
experiment questions identified preferences for four process attributes
(including parents’ ability to make a decision). Results: Midwives
employed by the UK National Health Service (n = 134) completed the survey. All
types of information content were perceived to improve parents’ ability to make
a decision except for the possibility of false-positive results. Late pregnancy
was seen to be the best time to provide information, followed by day 3
postbirth. Information before 20 weeks of pregnancy was viewed as reducing
parents’ ability to make a decision. Midwives preferred information to be
provided by an individual discussion and did not think parents should receive
information on the Internet. Conclusion: A hybrid stated preference
survey design identified that a wide variety of information should be provided
to maximize parents’ ability to make a decision ideally provided late in
pregnancy or on day 3 postbirth.
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Affiliation(s)
- Stuart James Wright
- Manchester Centre for Health Economics, Division of Population Health, Health Services Research & Primary Care (SJW, KP).,Division of Psychology and Mental Health (FU, ND).,Division of Nursing, Midwifery and Social Work (TL), the University of Manchester, Manchester, UK
| | - Fiona Ulph
- Manchester Centre for Health Economics, Division of Population Health, Health Services Research & Primary Care (SJW, KP).,Division of Psychology and Mental Health (FU, ND).,Division of Nursing, Midwifery and Social Work (TL), the University of Manchester, Manchester, UK
| | - Tina Lavender
- Manchester Centre for Health Economics, Division of Population Health, Health Services Research & Primary Care (SJW, KP).,Division of Psychology and Mental Health (FU, ND).,Division of Nursing, Midwifery and Social Work (TL), the University of Manchester, Manchester, UK
| | - Nimarta Dharni
- Manchester Centre for Health Economics, Division of Population Health, Health Services Research & Primary Care (SJW, KP).,Division of Psychology and Mental Health (FU, ND).,Division of Nursing, Midwifery and Social Work (TL), the University of Manchester, Manchester, UK
| | - Katherine Payne
- Manchester Centre for Health Economics, Division of Population Health, Health Services Research & Primary Care (SJW, KP).,Division of Psychology and Mental Health (FU, ND).,Division of Nursing, Midwifery and Social Work (TL), the University of Manchester, Manchester, UK
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15
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Heringa M, Floor-Schreudering A, Wouters H, De Smet PAGM, Bouvy ML. Preferences of Patients and Pharmacists with Regard to the Management of Drug-Drug Interactions: A Choice-Based Conjoint Analysis. Drug Saf 2018; 41:179-189. [PMID: 28965265 PMCID: PMC5808046 DOI: 10.1007/s40264-017-0601-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Introduction The management of drug–drug interactions (DDIs) is a complex process in which risk–benefit assessments should be combined with the patient’s perspective. Objective The aim of this study was to determine patients’ and pharmacists’ preferences regarding DDI management. Methods We conducted a choice-based conjoint survey about a fictitious DDI concerning the combination of a cardiovascular drug and an antibiotic for pneumonia. Patients and pharmacists had to choose 12 times between two management options. The options were described by five attributes, including risk, benefit and practical consequences. Each attribute could have two different levels, which were varied over the choice tasks. Latent class analysis was used to identify potential classes of respondents with distinct patterns of similar preferences. Results In total, 298 patients and 178 pharmacists completed the questionnaire. The latent class model for both patients and pharmacists resulted in three classes. For patients, in one class the most importance was attached to avoiding switch of medication (class probability 20%), in a second class to fewer adverse events (41%), and in a third class to blood sampling (39%). For pharmacists, again one class attached the highest importance to avoiding switch of medication (31%). The other classes gave priority to curing pneumonia (31%) and avoiding blood sampling (38%). Conclusion The results showed diverging preferences regarding DDI management among both patients and pharmacists. Different groups attached different value to risk and benefit versus practical considerations. Awareness of existing variability in preferences among and between pharmacists and patients is a step towards shared decision making in DDI management. Electronic supplementary material The online version of this article (doi:10.1007/s40264-017-0601-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mette Heringa
- SIR Institute for Pharmacy Practice and Policy, Theda Mansholtstraat 5B, 2331 JE, Leiden, The Netherlands. .,Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands. .,Health Base Foundation, Houten, The Netherlands.
| | - Annemieke Floor-Schreudering
- SIR Institute for Pharmacy Practice and Policy, Theda Mansholtstraat 5B, 2331 JE, Leiden, The Netherlands.,Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Hans Wouters
- Department of Pharmacotherapy, -Epidemiology and -Economics, Groningen University, Groningen, The Netherlands
| | - Peter A G M De Smet
- Departments of Clinical Pharmacy and IQ Healthcare, University Medical Centre St Radboud, Nijmegen, The Netherlands
| | - Marcel L Bouvy
- SIR Institute for Pharmacy Practice and Policy, Theda Mansholtstraat 5B, 2331 JE, Leiden, The Netherlands.,Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
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