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Qin T, Gu M, Wang Y, Yang Y, Guo J, Li X, Wang Y, Gao J, Bai Y. What's the preferences of medical staff for providing health education service? - A discrete choice experiment in Beijing, China. PATIENT EDUCATION AND COUNSELING 2024; 124:108282. [PMID: 38593483 DOI: 10.1016/j.pec.2024.108282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 03/09/2024] [Accepted: 03/28/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVE To quantify medical staff preferences for providing health education service in hospitals. METHODS This study took medical staff in the department of internal medicine of hospitals in Beijing, China as the research subjects, and designed a discrete choice experiment (DCE) to investigate the health education service provision preferences of them. Through various methods, 8 attributes and corresponding levels were determined. An online survey was conducted among the medical staff of the sample hospitals from May to June 2023. Participants' preferences were analyzed using conditional logit and mixed logit models. RESULTS Finally, 831 respondents completed the questionnaire, among which 600 cases passed the consistency test. All the attributes included in this study had an impact on medical staff' health education service preferences (P < 0.001). The most important one with the greatest impact on the health education service delivery behavior of the respondents was "department working atmosphere-encouraging health education" (β = 4.062, P < 0.001). CONCLUSION In this study, the departmental work atmosphere and performance bonuses emerged as crucial factors influencing the engagement of medical staff in health education work. PRACTICAL IMPLICATIONS Hospitals should prioritize measures to improve the health education working atmosphere in departments to increase the enthusiasm of medical staff to provide services.
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Affiliation(s)
- Tingting Qin
- School of Public Health, Capital Medical University, Beijing, China
| | - Mingyu Gu
- School of Public Health, Capital Medical University, Beijing, China
| | - Yao Wang
- School of Public Health, Capital Medical University, Beijing, China
| | - Yutong Yang
- School of Public Health, Capital Medical University, Beijing, China
| | - Junjun Guo
- School of Public Health, Capital Medical University, Beijing, China
| | - Xingming Li
- School of Public Health, Capital Medical University, Beijing, China.
| | - Yueyong Wang
- School of Public Health, Capital Medical University, Beijing, China
| | - Jie Gao
- School of Public Health, Capital Medical University, Beijing, China
| | - Yu Bai
- School of Public Health, Capital Medical University, Beijing, China
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Zindel Z, de Vries L. Career sacrifice for an LGBTQ*-friendly work environment? a choice experiment to investigate the job preferences of LGBTQ* people. PLoS One 2024; 19:e0296419. [PMID: 38913684 PMCID: PMC11195964 DOI: 10.1371/journal.pone.0296419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/12/2023] [Indexed: 06/26/2024] Open
Abstract
Recent research in economics and sociology demonstrates the existence of significant occupational segregation by sexual orientation and gender identity and differences in a range of labor market outcomes, such as hiring chances, earnings, and leadership positions. In this paper, we examine one possible cause of these differences that is associated with the disadvantaged position of sexual and gender minorities in the labor market: LGBTQ* individuals' choices aimed at avoiding possible discrimination. This paper examines LGBTQ* people's relative importance of income, time, promotion prospects, an LGBTQ*-friendly work environment, and diversity management in the decision for or against a job. Based on a discrete choice experiment conducted in a large online sample recruited through social media in Germany (N = 4,507), an LGBTQ*-friendly work climate accounted, on average, for 33.8 percent of respondents' decisions which is comparable with the relative importance of income. Overtime, a diversity management on company level and promotion prospects are less important in the job decision process of LGBTQ* people. While the results show only small differences by sexual orientation, they show group-specific preferences by gender identity. An LGBTQ*-friendly work climate is more important for cisgender women of the LGBTQ* community and gender minorities than for cisgender men of the LGBTQ* community. In contrast, income is less important for gender minorities and cisgender women of the LGBTQ* community than for cisgender men of the LGBTQ* community.
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Affiliation(s)
- Zaza Zindel
- Faculty of Sociology, Bielefeld University, Bielefeld, Germany
| | - Lisa de Vries
- Faculty of Sociology, Bielefeld University, Bielefeld, Germany
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Löfvendahl S, Andersson E, Olofsson S, Wahlberg K, Bjermer L, Tornling G, Hjelmgren J. Treatment Preferences for Acute Allergic Reactions: A Discrete Choice Experiment. JOURNAL OF HEALTH ECONOMICS AND OUTCOMES RESEARCH 2024; 11:157-165. [PMID: 38845782 PMCID: PMC11156467 DOI: 10.36469/001c.117589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 05/14/2024] [Indexed: 06/09/2024]
Abstract
Background: Timely treatment of acute allergic reactions (AARs) is important to minimize reaction severity. Corticosteroid tablets dissolved in water are commonly used in mainstay treatment. A new oral film that dissolves on the tongue provides a faster and less cumbersome alternative to tablets for corticosteroid administration during AARs. This study evaluated patients' preferences for attributes related to administration mode of corticosteroids in AARs. Methods: A web-based survey was sent to a sample from the adult Swedish population (≥18 years) with experience of corticosteroid treatment for AAR. We assessed the willingness to pay (WTP) for attributes related to corticosteroid treatment by applying a discrete choice experiment (DCE) approach. DCE attributes were administration mode, time to symptom relief, and price. The WTP for each attribute was derived using the attribute's coefficient in a logistic regression analysis. We specified a forced choice (FC) and an unforced choice (UC) model. In the FC model, the respondents chose between 2 hypothetical treatments and in the UC model, between any of 2 hypothetical treatments and their current treatment. Results: The final study population included 348 subjects, of which 80% were women. All the evaluated DCE attributes were significant predictors for the treatment choice (p<.001). In the FC model, the incremental WTP for an oral film compared with tablets was 409 Swedish kronor (SEK [≈€36.7]), with no other factors considered. In the UC model, the incremental WTP for the oral film compared with tablets was 574 SEK (≈€51.7). After considering the value of the respondents' current treatment, the WTP for the oral film decreased to 336 SEK (≈€30.3). The total WTP was reduced by 17 SEK (≈€1.5) per minute of shorter time to symptom relief. Subgroup analyses showed that people with circulatory symptoms and experience of swallowing difficulties related to allergy medication had higher WTP for the oral film than the average respondent. Conclusion: The findings show a substantial economic benefit of the oral film vs tablets for patients with AARs in Sweden. This result remained also after compensation for the full value of the patients' current treatment.
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Affiliation(s)
| | | | - Sara Olofsson
- The Swedish Institute for Health Economics (IHE), Lund, Sweden
| | - Karin Wahlberg
- The Swedish Institute for Health Economics (IHE), Lund, Sweden
| | - Leif Bjermer
- Department of Respiratory Medicine and AllergologyLund University, Lund, Sweden
| | - Göran Tornling
- Respiratory Medicine Division, Department of Medicine SolnaKarolinska Institutet
| | - Jonas Hjelmgren
- The Swedish Institute for Health Economics (IHE), Lund, Sweden
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Rutsaert P, Donovan J, Murphy M, Hoffmann V. Farmer decision making for hybrid maize seed purchases: Effects of brand loyalty, price discounts and product information. AGRICULTURAL SYSTEMS 2024; 218:104002. [PMID: 38911698 PMCID: PMC11188992 DOI: 10.1016/j.agsy.2024.104002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 05/08/2024] [Accepted: 05/13/2024] [Indexed: 06/25/2024]
Abstract
CONTEXT Each year public and private sector maize breeding programs in Kenya deliver high-yielding hybrids that are resistant to drought, pests, and diseases. Yet, most Kenyan maize farmers purchase older, well-known hybrids. While the 'varietal turnover' problem is well known, few solutions have emerged. OBJECTIVE The potential for seed companies and retailers to influence farmers' product selection towards new products remains an open question. In-store marketing that induces farmers to experiment with new products may be a scalable and cost-effective way to advance seed systems development. METHODS Our controlled field experiment with 600 farmers in Kenya comprised a mock agrodealer store stocked with locally available hybrids, where half the farmers who participated faced an out-of-stock situation for their preferred product. The influence of price promotions and product performance information on farmers' seed choice were assessed. RESULTS AND CONCLUSIONS When a participant's preferred product was available, performance information and discounts had no effect on decisions. However, when the preferred product was unavailable, the treatments had limited effects on product selection. Prior experience and brand loyalty stood out as the strongest predictors of seed product selection. SIGNIFICANCE Our work explored the potential for two interventions-information and price discounts-to influence farmers' product selection. While these interventions showed limited influence on selection, the study design provides a clear starting point for future related experiments. More public and private investments are required to generate timely, comparable, and reliable information on seed performance. The strong effect of brand loyalty favors larger-sized seed companies with sizable marketing budgets.
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Affiliation(s)
- Pieter Rutsaert
- International Maize and Wheat Improvement Centre (CIMMYT), Nairobi, Kenya
| | - Jason Donovan
- International Maize and Wheat Improvement Centre (CIMMYT), Texcoco, Mexico
| | - Mike Murphy
- International Food Policy Research Institute (IFPRI), Washington, DC, USA
| | - Vivian Hoffmann
- International Food Policy Research Institute (IFPRI), Washington, DC, USA
- Carleton University, Ottawa, ON, Canada
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Le Stum M, Clave A, Adzinyo Agbemanyole K, Stindel E, Le Goff-Pronost M. A pilot study on preferences from surgeons to deal with an innovative customized and connected knee prosthesis - A discret choice experiment. Heliyon 2024; 10:e30041. [PMID: 38784553 PMCID: PMC11112283 DOI: 10.1016/j.heliyon.2024.e30041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 05/25/2024] Open
Abstract
Background To address the increasing global demand for Total Knee Arthroplasty and reduce the need for revisions, several technologies combining 3D planning and artificial intelligence have emerged. These innovations aim to enhance customization, improve component positioning accuracy and precision. The integration of these advancements paves the way for the development of personalized and connected knee implant. Questions/purposes These groundbreaking advancements may necessitate changes in surgical practices. Hence, it is important to comprehend surgeons' intentions in integrating these technologies into their routine procedures. Our study aims to assess how surgeons' preferences will affect the acceptability of using this new implant and associated technologies within the entire care chain. Methods We employed a Discrete Choice Experiment, a predictive technique mirroring real-world healthcare decisions, to assess surgeons' trade-off evaluations and preferences. Results A total of 90 experienced surgeons, performing a significant number of procedures annually (mostly over 51) answered. Analysis indicates an affinity for technology but limited interest in integrating digital advancements like preoperative software and robotics. However, they are receptive to practice improvements and considering the adoption of future sensors. Conclusions In conclusion, surgeons prefer customized prostheses via augmented reality, accepting extra cost. Embedded sensor technology is deemed premature by them.
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Affiliation(s)
- Mathieu Le Stum
- Université de Brest, UBO, LATIM, UMR 1101, 22 rue Camille Desmoulins, 29200, Brest, France
- Institut National de la Santé et de la Recherche Médicale, Inserm, LaTIM, UMR 1101, 22 rue Camille Desmoulins, 29200, Brest, France
| | - Arnaud Clave
- Service d'orthopédie, Clinique Saint George, 2 Avenue de Rimiez, 06100, Nice, France
| | - Koffi Adzinyo Agbemanyole
- Institut Mines-Telecom, IMT Atlantique, LATIM, UMR 1101, M@rsouin, 655 Av. du Technopôle, 29280, Plouzané, France
| | - Eric Stindel
- Université de Brest, UBO, LATIM, UMR 1101, 22 rue Camille Desmoulins, 29200, Brest, France
- Centre Hospitalo-Universitaire de Brest, CHU Brest, LATIM, UMR 1101, 2 Avenue Foch, 29200, Brest, France
| | - Myriam Le Goff-Pronost
- Institut Mines-Telecom, IMT Atlantique, LATIM, UMR 1101, M@rsouin, 655 Av. du Technopôle, 29280, Plouzané, France
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Whitty JA, Lancsar E, De Abreu Lourenco R, Howard K, Stolk EA. Putting the Choice in Choice Tasks: Incorporating Preference Elicitation Tasks in Health Preference Research. THE PATIENT 2024:10.1007/s40271-024-00696-5. [PMID: 38744798 DOI: 10.1007/s40271-024-00696-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/08/2024] [Indexed: 05/16/2024]
Abstract
Choice-based preference elicitation methods such as the discrete choice experiment (DCE) present hypothetical choices to respondents, with an expectation that these hypothetical choices accurately reflect a 'real world' health-related decision context and that consequently the choice data can be held to be a true representation of the respondent's health or treatment preferences. For this to be the case, careful consideration needs to be given to the format of the choice task in a choice experiment. The overarching aim of this paper is to highlight important aspects to consider when designing and 'setting up' the choice tasks to be presented to respondents in a DCE. This includes the importance of considering the potential impact of format (e.g. choice context, choice set presentation and size) as well as choice set content (e.g. labelled and unlabelled choice sets and inclusion of reference alternatives) and choice questions (stated choice versus additional questions designed to explore complete preference orders) on the preference estimates that are elicited from studies. We endeavoure to instil a holistic approach to choice task design that considers format alongside content, experimental design and analysis.
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Affiliation(s)
- Jennifer A Whitty
- Patient-Centred Research, Evidera, London, UK.
- Norwich Medical School, The University of East Anglia, Norwich, UK.
| | - Emily Lancsar
- Department of Health Economics Wellbeing and Society, Australian National University, Acton, ACT, Australia
| | - Richard De Abreu Lourenco
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia
| | - Kirsten Howard
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia
| | - Elly A Stolk
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
- EuroQol Research Foundation, Rotterdam, The Netherlands
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Liu Y, Du S, Liu C, Xue T, Tang Y. Preference of primary care patients for home-based healthcare and support services: a discrete choice experiment in China. Front Public Health 2024; 12:1324776. [PMID: 38699415 PMCID: PMC11063295 DOI: 10.3389/fpubh.2024.1324776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 04/08/2024] [Indexed: 05/05/2024] Open
Abstract
Importance This research, utilizing discrete choice experiments, examines the preferences and willingness to pay for home-based healthcare and support services among residents in China, a country grappling with severe aging population, an area often underexplored in international scholarship. Objectives This study aims to solicit the preferences of primary care patients for home-based healthcare and support services in China. Design setting and participants A discrete choice experiment (DCE) was conducted on 312 primary care patients recruited from 13 community health centers in Wuhan and Kunming between January and May 2023. The experimental choice sets were generated using NGene, covering five attributes: Scope of services, health professionals, institutions, insurance reimbursements, and visiting fees. Main outcomes and measures The choice sets were further divided into three blocks, and each participant was asked to complete one block containing 12 choice tasks. Mixed logit models were established to estimate the relevant importance coefficients of and willingness to pay for different choices, while Latent Class Logit (LCL) modeling was conducted to capture possible preferences heterogeneity. Results The relevant importance of the scope of services reached 67.33%, compared with 19.84% for service institutions and 12.42% for health professionals. Overall, respondents preferred physician-led diagnostic and treatment services. LCL categorized the respondents into three groups: Group one (60.20%) was most concerned about the scope of services, prioritizing disease diagnosis and treatment over preventive care and mental health, while group two (16.60%) was most concerned about care providers (hospitals and medical doctors were preferred), and group three (23.20%) was most concerned about financial burdens. Conclusion Primary care patients prefer physical health and medical interventions for home-based healthcare and support services. However, heterogeneity in preferences is evident, indicating potential disparities in healthcare and support at home services in China.
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Affiliation(s)
- Yaqing Liu
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Sixian Du
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chaojie Liu
- Department of Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Tianqin Xue
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yuqing Tang
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Research Institute of Humanities and Social Sciences of Hubei Provincial Department of Education, Wuhan, Hubei, China
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Gawronski BE, Salloum RG, Duarte JD. Estimating preferences and willingness to pay for pharmacogenetic testing in populations who are medically underserved: a discrete choice experiment. Front Pharmacol 2024; 15:1384667. [PMID: 38595920 PMCID: PMC11002086 DOI: 10.3389/fphar.2024.1384667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 03/14/2024] [Indexed: 04/11/2024] Open
Abstract
Background: The implementation of pharmacogenetic (PGx) testing may contribute to health disparities if access to testing is inequitable, as medically underserved patients are prescribed higher rates of drugs with PGx guidelines and often experience the benefits of emerging health technologies last. Limited research has evaluated potential implementation of PGx testing in populations who are medically underserved and none have evaluated their preferences regarding PGx test characteristics and cost. Our study endeavored to assess the willingness to pay for PGx testing and key PGx test preferences in a nationwide cohort of medically underserved respondents. Methods: A survey was developed to assess willingness to pay and preferences for PGx testing through a discrete choice experiment (DCE). Five attributes of PGx tests were included in the DCE: doctor recommendation, wait time, number of actionable results, benefit of the test (avoid a side effect or address a health problem), and out-of-pocket cost. A convenience sample of U.S. adults with an average yearly household income of $42,000 or less was collected utilizing an online survey fielded by Qualtrics Research Services (Provo, UT). For the DCE analysis, conditional logit and mixed-logit regression models were utilized to determine relative utility of attributes and levels, conditional relative importance for each attribute, and marginal willingness to pay. Results: Respondents completed the survey with an 83.1% response completion rate. Following quality control procedures, 1,060 respondents were included in the final nationwide cohort. Approximately, 82% of respondents were willing to pay less than $100 for PGx testing, and a strong price ceiling was identified at $200. Out-of-pocket cost was the attribute identified as having the greatest relative importance on choice, while wait time had the lowest importance. Greater utility was observed if the PGx test was doctor recommended, had a higher number of actionable results, and resolved major or minor health problems compared with avoiding side effects. Conclusion: This first-of-its-kind study provides important insights into the willingness to pay for PGx testing and PGx test preferences of a large medically underserved population. Applying these findings can potentially lead to improvements in the successful implementation of PGx testing in this population.
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Affiliation(s)
- Brian E. Gawronski
- Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - Ramzi G. Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Julio D. Duarte
- Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, FL, United States
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Yin Y, Peng Q, Ma L, Dong Y, Sun Y, Xu S, Ding N, Liu X, Zhao M, Tang Y, Mei Z, Shao H, Yan D, Tang W. QALY-type preference and willingness-to-pay among end-of-life patients with cancer treatments: a pilot study using discrete choice experiment. Qual Life Res 2024; 33:753-765. [PMID: 38079024 DOI: 10.1007/s11136-023-03562-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2023] [Indexed: 02/26/2024]
Abstract
PURPOSE Quality-adjusted life-year (QALY) is a dominant measurement of health gain in economic evaluations for pricing drugs. However, end-of-life (EoL) patients' preference for QALY gains in life expectancy (LE) and quality of life (QoL) during different disease stages remains unknown and is seldom involved in decision-making. This study aims to measure preferences and willingness-to-pay (WTP) towards different types of QALY gain among EoL cancer patients. METHODS We attributed QALY gain to four types, gain in LE and QoL, respectively, and during both progression-free survival (PFS) and post-progression survival (PPS). A discrete choice experiment including five attributes (the four QALY attributes and one cost attribute) with three levels each was developed and conducted with 85 Chinese advanced non-small cell lung cancer patients in 2022. All levels were set with QALY gain/cost synthesised from research on anti-lung cancer drugs recently listed by Chinese National Healthcare Security Administration. Each respondent answered six choice tasks in a face-to-face interview. The data were analysed using mixed logit models. RESULTS Patients valued LE-related QALY gain in PFS most, with a relative importance of 81.8% and a WTP of $43,160 [95% CI 26,751 ~ 59,569] per QALY gain. Respondents consistently preferred LE-related to QoL-related QALY gain regardless of disease stage. Patients with higher income or lower education levels tended to pay more for QoL-related QALY gain. CONCLUSION Our findings suggest a prioritised resource allocation to EoL-prolonging health technologies. Given the small sample size and large individual heterogeneity, a full-scale study is needed to provide more robust results.
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Affiliation(s)
- Yue Yin
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 211198, China
- Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, 211198, China
| | - Qian Peng
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 211198, China
- Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, 211198, China
| | - Longhao Ma
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 211198, China
| | - Yi Dong
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 211198, China
| | - Yinan Sun
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 211198, China
| | - Silu Xu
- Department of Pharmacy, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China
| | - Nianyang Ding
- Department of Pharmacy, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China
| | - Xiaolin Liu
- Department of Pharmacy, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China
| | - Mingye Zhao
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 211198, China
- Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, 211198, China
| | - Yaqian Tang
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 211198, China
- Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, 211198, China
| | - Zhiqing Mei
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 211198, China
- Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, 211198, China
| | - Hanqiao Shao
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 211198, China
- Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, 211198, China
| | - Dan Yan
- Department of Pharmacy, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China.
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 211198, China.
| | - Wenxi Tang
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 211198, China.
- Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, 211198, China.
- Department of Public Management, School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 211198, China.
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Hamilton M, Christine Lin CW, Arora S, Harrison M, Tracy M, Nickel B, Shaheed CA, Gnjidic D, Mathieson S. Understanding general practitioners' prescribing choices to patients with chronic low back pain: a discrete choice experiment. Int J Clin Pharm 2024; 46:111-121. [PMID: 37882955 PMCID: PMC10831024 DOI: 10.1007/s11096-023-01649-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/07/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Although NSAIDs are recommended as a first line analgesic treatment, opioids are very commonly prescribed to patients with low back pain (LBP) despite risks of harms. AIM This study aimed to determine factors contributing to general practitioners' (GPs') prescribing choices to patients with chronic LBP in a primary care setting. METHOD This discrete choice experiment (DCE) presented 210 GPs with hypothetical scenarios of a patient with chronic LBP. Participants chose their preferred treatment for each choice set, either the opioid, NSAID or neither. The scenarios varied by two patient attributes; non-specific LBP or LBP with referred leg pain (sciatica) and number of comorbidities. The three treatment attributes also varied, being: the type of opioid or NSAID, degree of pain reduction and number of adverse events. The significance of each attribute in influencing clinical decisions was the primary outcome and the degree to which GPs preferred the alternative based on the number of adverse events or the amount of pain reduction was the secondary outcome. RESULTS Overall, GPs preferred NSAIDs (45.2%, 95% CI 38.7-51.7%) over opioids (28.8%, 95% CI 23.0-34.7%), however there was no difference between the type of NSAID or opioid preferred. Additionally, the attributes of pain reduction and adverse events did not influence a GP's choice between NSAIDs or opioids for patients with chronic LBP. CONCLUSION GPs prefer prescribing NSAIDs over opioids for a patient with chronic low back pain regardless of patient factors of comorbidities or the presence of leg pain (i.e. sciatica).
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Affiliation(s)
- Melanie Hamilton
- Institute for Musculoskeletal Health, Level 10 North, King George V Building, Royal Prince Alfred Hospital (C39), Missenden Road, PO Box M179, Camperdown, Sydney, NSW, 2050, Australia.
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Chung-Wei Christine Lin
- Institute for Musculoskeletal Health, Level 10 North, King George V Building, Royal Prince Alfred Hospital (C39), Missenden Road, PO Box M179, Camperdown, Sydney, NSW, 2050, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Sheena Arora
- Centre for Health Economics Research and Evaluation, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Mark Harrison
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
- The Centre for Health Evaluation and Outcomes Sciences (CHEOS) at St. Paul's Hospital, Vancouver, Canada
| | - Marguerite Tracy
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Brooke Nickel
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Christina Abdel Shaheed
- Institute for Musculoskeletal Health, Level 10 North, King George V Building, Royal Prince Alfred Hospital (C39), Missenden Road, PO Box M179, Camperdown, Sydney, NSW, 2050, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Danijela Gnjidic
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Stephanie Mathieson
- Institute for Musculoskeletal Health, Level 10 North, King George V Building, Royal Prince Alfred Hospital (C39), Missenden Road, PO Box M179, Camperdown, Sydney, NSW, 2050, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Tervonen T, Whichello C, Law E, Mauer J, Mitra D, Trapali M, Krucien N, Hauber B. Treatment preferences of adults and adolescents with alopecia areata: A discrete choice experiment. J Dermatol 2024; 51:243-252. [PMID: 38087841 DOI: 10.1111/1346-8138.17056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 10/29/2023] [Accepted: 11/09/2023] [Indexed: 02/04/2024]
Abstract
PRODUCTS with janus kinase (JAK) inhibition have been shown to promote hair regrowth in patients with alopecia areata (AA). To guide drug-approval and treatment decisions, it is important to understand patients' willingness to accept the potential risks of JAK inhibition in exchange for potential benefits. We quantified the treatment preferences of adult (≥18 years) and adolescent patients (12-17 years) with AA in the US and Europe to determine the trade-offs they are willing to make between benefits and risks. Preferences for oral AA treatment attributes were elicited using a discrete choice experiment consisting of 12 tasks in which patients chose between two hypothetical treatment alternatives and no treatment. Benefits included the probability of 80%-100% scalp hair regrowth (Severity of Alopecia Tool score ≤ 20) and achieving moderate-to-normal eyebrow and eyelash hair. Treatment-related risks included 3-year probabilities of serious infection, cancer, and blood clots. Preference estimates were used to calculate the maximum level of each risk that patients were willing to accept for increases in treatment benefits. The most important attribute to both adults (n = 201) and adolescents (n = 120) was a 50% probability of achieving hair regrowth on most or all the scalp; however, adolescents placed greater relative importance on this attribute than did adults. Adults were averse to the risks of serious infection, cancer, and blood clots, whereas adolescents were averse to the risk of cancer. For a 20% increase in the probability of 80%-100% scalp hair regrowth, adults were willing to accept a mean (95% confidence interval) 3-year risk of serious infection, cancer, and blood clots of 7.4% (5.5-9.3), 2.5% (1.9-3.1), and 9.3% (6.4-12.2). Adolescents were willing to accept a 3-year risk of cancer of 3.3% (2.4-4.2). Patients with AA in the US and Europe are willing to accept substantial risks to obtain an effective treatment.
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Affiliation(s)
| | | | - Ernest Law
- Pfizer Inc., New York City, New York, USA
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Du J, Ji W, Zhao H, McIver DJ, Zhao Y, Chang J, Fang Y. Preferences of pregnant women toward a future maternal Group B Streptococcus vaccine in China: A cross-sectional survey with a discrete choice experiment. Hum Vaccin Immunother 2023; 19:2281713. [PMID: 38175949 PMCID: PMC10760376 DOI: 10.1080/21645515.2023.2281713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/03/2023] [Indexed: 01/06/2024] Open
Abstract
Group B streptococcus (GBS) is a major cause of neonatal death worldwide. A GBS vaccine for pregnant women is under development and is expected to be available in the near future. The perceptions and preferences of pregnant women in China of GBS vaccines has not been investigated, and this study aimed to investigate pregnant women's awareness of GBS and their potential preferences for the GBS vaccine. A discrete choice experiment was conducted among pregnant women in hospitals from Shaanxi, Hunan, and Zhejiang provinces located in Western, Central, and Eastern China, respectively. A conditional logit model was used to analyze the data and calculate willingness to pay values and choice probabilities of different GBS vaccine programs. A total of 354 pregnant women were included in the final analysis, 45.8% of whom were willing to receive a GBS vaccine if it were licensed. Vaccine safety was the most important attribute of a future vaccine, while cost was the least important attribute. Compared with no vaccination, pregnant women had a strong preference for future GBS vaccination (ASC = 1.267, p < .001). Pregnant women's decisions were highly influenced by those of other pregnant women. Improving the safety, efficacy, and vaccination rate of the GBS vaccine in China is of great significance for future GBS vaccine development and vaccination. Compared to other variable options, the cost of a GBS vaccine was of the least importance among pregnant women in mainland China. These findings can inform public health policy decisions related to GBS vaccination in China.
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Affiliation(s)
- Jiaxi Du
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China’s Western Technological Innovation Harbor, Xi’an, China
| | - Wenjing Ji
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China’s Western Technological Innovation Harbor, Xi’an, China
| | - Hang Zhao
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China’s Western Technological Innovation Harbor, Xi’an, China
| | - David J. McIver
- Institute for Global Health Sciences, University of California, San Fransisco, CA, USA
| | - Yifei Zhao
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China’s Western Technological Innovation Harbor, Xi’an, China
| | - Jie Chang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China’s Western Technological Innovation Harbor, Xi’an, China
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China’s Western Technological Innovation Harbor, Xi’an, China
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Nguyen HM, Baradaran M, Daigle G, Nshimyumukiza L, Guertin JR, Reinharz D. Pregnant women's and policymakers' preferences for the expansion of noninvasive prenatal screening: A discrete choice experiment approach study. Health Sci Rep 2023; 6:e1516. [PMID: 37636285 PMCID: PMC10447874 DOI: 10.1002/hsr2.1516] [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] [Received: 05/01/2023] [Revised: 07/12/2023] [Accepted: 08/09/2023] [Indexed: 08/29/2023] Open
Abstract
Background and Aims Quantitative approaches for eliciting preferences for new interventions are mostly conducted by patients and rarely by policymakers. This study aimed to quantify the preferences of pregnant women and policymakers regarding the addition of a new test to prenatal screening programs for detecting chromosomal abnormalities. Methods A discrete choice experiment was conducted to measure the respondents' preferences for a new prenatal test. A seven-attribute instrument was built based on interviews with pregnant women and policymakers. The data were analyzed using robust conditional logistic regression and nested logit models. Results In total, 272 pregnant women and 24 policymakers completed the questionnaire (response rates of 48% and 55%, respectively). Overall, all attributes were statistically significant in the pregnant women group, whereas only three attributes (test performance, degree of test result certainty, and cost) were statistically significant in the policymakers group. Statistically significant differences in test performance and information were observed between the two groups. Conclusion Policymakers differed from pregnant women in their appraisal of attributes related to their preference for a new prenatal screening intervention. The low response rates observed in both groups suggest that further investigation of the relevance of this approach must be conducted.
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Affiliation(s)
- Hung Manh Nguyen
- Département de médecine sociale et préventiveUniversité LavalQuébecCanada
| | - Mohammad Baradaran
- Département de génie électrique et de génie informatiqueUniversité LavalQuébecCanada
| | - Gaétan Daigle
- Département de mathématiques et de statistiqueUniversité LavalQuébecCanada
| | - Leon Nshimyumukiza
- Institut national d'excellence en santé et en services sociauxQuébecCanada
- Faculté des sciences infirmièresUniversité LavalQuébecCanada
| | - Jason Robert Guertin
- Département de médecine sociale et préventiveUniversité LavalQuébecCanada
- Centre de Recherche du CHU de QuébecUniversité LavalQuébecCanada
| | - Daniel Reinharz
- Département de médecine sociale et préventiveUniversité LavalQuébecCanada
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Wang Y, Zhai P, Jiang S, Li C, Li S. Blood Donors' Preferences Toward Incentives for Donation in China. JAMA Netw Open 2023; 6:e2318320. [PMID: 37314802 PMCID: PMC10267764 DOI: 10.1001/jamanetworkopen.2023.18320] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 04/28/2023] [Indexed: 06/15/2023] Open
Abstract
Importance Blood donation is critical for health care systems, but donor retention remains challenging. Understanding donors' preferences can inform incentive design and improve retention rates. Objective To identify donor preferences for incentive attributes and their relative importance in promoting blood donation among Chinese donors in Shandong. Design, Setting, and Participants This survey study fielded a discrete choice experiment (DCE) with a dual response design among blood donors, analyzing the responses under forced and unforced choice settings. The study took place from January 1 to April 30, 2022, in 3 cities (Yantai, Jinan, and Heze) representing diverse socioeconomic strata in Shandong, China. Eligible participants were blood donors aged 18 to 60 years who had donated within the preceding 12 months. Participants were recruited using convenience sampling. Data were analyzed from May to June 2022. Exposure Respondents were presented with different blood donation incentive profiles, varying in health examination, blood recipient, honor recognition, travel time, and gift value. Main Outcome and Measure Respondent preferences for nonmonetary incentive attributes, attribute relative importance, willingness-to-discard values for attribute improvement, and estimated uptake of new incentive profiles. Results A total of 650 donors were invited, of which 477 were included for analysis. The respondents were predominately male (308 respondents [64.6%]), aged 18 to 34 years (291 respondents [61.0%]), and had undergraduate degrees or higher (286 respondents [59.9%]). Among the 477 valid respondents, the mean (SD) age was 31.9 (11.2) years. Respondents preferred comprehensive health examination, family members as recipients, central government recognition, 30-minute travel time, and a gift valued at 60 Renminbi (RMB). No significant differences were found between the model results of forced and unforced choice setting. Blood recipient was the most important attribute, followed by health examination and gifts, and then honor and travel time. Respondents were willing to discard RMB 32 (95% CI, 18-46) for an improved health examination and RMB 69 (95% CI, 47-92) for changing the recipient from themselves to family members. Scenario analysis estimated 80.3% (SE, 0.024) of donors would endorse the new incentive profile if the recipient was changed from themselves to family members. Conclusions and Relevance In this survey study, blood recipient, health examination, and gift value were perceived more important as nonmonetary incentives than travel time and honor recognition. Tailoring incentives according to these preferences may improve donor retention. Further research could help refine and optimize incentive schemes for blood donation promotion.
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Affiliation(s)
- Yu Wang
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
- Center for Health Preference Research, Shandong University, Jinan, Shandong, China
| | - Peicong Zhai
- Blood Center of Shandong Province, Jinan, Shandong, China
| | - Shan Jiang
- Macquarie University Centre for the Health Economy, Macquarie Business School and Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Chaofan Li
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
- Center for Health Preference Research, Shandong University, Jinan, Shandong, China
| | - Shunping Li
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
- Center for Health Preference Research, Shandong University, Jinan, Shandong, China
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Seo J, Heidenreich S, Aldalooj E, Poon JL, Spaepen E, Eby EL, Newson RS. Patients' Preferences for Connected Insulin Pens: A Discrete Choice Experiment Among Patients with Type 1 and Type 2 Diabetes. THE PATIENT 2023; 16:127-138. [PMID: 36437389 PMCID: PMC9911509 DOI: 10.1007/s40271-022-00610-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/03/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study quantified how people with diabetes value the unique features of connected insulin pens and related mobile apps, and the underlying reasons for preferring connected versus non-connected insulin pens. METHODS A discrete choice experiment (DCE) was conducted in the USA and UK to elicit preferences of adults (≥ 18 years) with type 1 or 2 diabetes for attributes of insulin pens. Attributes included device type, dosing support, glucose monitoring, additional app features, and data sharing. Relative attribute importance (RAI) scores were calculated to capture the relative importance of an attribute. Predicted choice probabilities were obtained to compare different profiles for connected and non-connected insulin pens. RESULTS The DCE was completed by 540 participants (58.9% male; 90.7% Caucasian; mean age, 58.3 years; 69.4% type 2 diabetes). Participants most valued the possibility of using a connected insulin pen with dosing support and automated dose logging (RAI = 39.9%), followed by automatic transfer of glucose levels (RAI = 29.0%), additional features of tracking diet and physical activity (RAI = 14.6%), data sharing (RAI = 13.6%), and device type (RAI = 2.9%). All profiles of connected insulin pens were preferred over a non-connected pen (p < 0.001), and pen profiles with advanced features were preferred over those without (p < 0.001). Preferences differed by age but not diabetes type, country of residence, or insulin regimen. CONCLUSION People with diabetes in the USA and UK prefer connected over non-connected insulin pens due largely to the availability of automated logging of dose and glucose levels.
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Affiliation(s)
- Jaein Seo
- Patient-Centered Research, Evidera, Bethesda, MD, USA
| | | | | | - Jiat Ling Poon
- Value, Evidence, and Outcomes, Eli Lilly and Co, Indianapolis, IN, USA
| | | | - Elizabeth L Eby
- Value, Evidence, and Outcomes, Eli Lilly and Co, Indianapolis, IN, USA
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Pereira CCDA, Torres TS, Luz PM, Hoagland B, Farias A, Brito JDU, Lacerda MVG, Silva DAR, Benedetti M, Pimenta MC, Grinsztejn B, Veloso VG. Preferences for pre-exposure prophylaxis (PrEP) among sexual and gender minorities: a discrete choice experiment in Brazil. LANCET REGIONAL HEALTH. AMERICAS 2023; 19:100432. [PMID: 36950036 PMCID: PMC10025414 DOI: 10.1016/j.lana.2023.100432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 10/27/2022] [Accepted: 01/10/2023] [Indexed: 02/09/2023]
Abstract
Background Men who have sex with men (MSM) and transgender women (TGW) are disproportionally affected by HIV infection in Latin America. This study aims to assess pre-exposure prophylaxis (PrEP) preferences among sexual and gender minorities (SGM) and identify attributes and levels that are related to PrEP uptake and adherence, both crucial for PrEP success. Methods We conducted a discrete choice experiment (DCE) among SGM from all Brazilian regions (September-December/2020). The survey was administered face-to-face (five Brazilian capitals) and online (entire country). We used a D-efficient zero-prior blocked experimental design to select 60 paired-profile DCE choice tasks. Findings The total sample size was 3924 (90.5% MSM; 7.2% TGW and 2.3% non-binary or gender diverse persons). In random-effects logit models, highest levels of protection and "no side effects" were the most important attribute levels. For "presentation", injectable and implant were preferred over oral. Participants were willing to accept a 4.1% protection reduction to receive injectable PrEP or a 4.2% reduction if PrEP were taken monthly. The largest class in the latent class models was defined predominantly by the preference for the highest HIV protection level (p < 0.005). Respondents in this class also preferred no side effects, injectable and implant presentations. Interpretation Higher HIV protection, no side effects, and presentation, whether injectable or implant, were the most important attributes in PrEP preferences. Protection against HIV was the most important attribute. PrEP programs should make available technologies such as long-acting presentations that could reunite the most desired attributes, thus maximizing acceptability and user-appropriateness. Funding Unitaid.
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Affiliation(s)
| | - Thiago Silva Torres
- Laboratório de Pesquisa Clínica em HIV/AIDS (LapClin-AIDS), Instituto Nacional de Infectologia Evandro Chagas – INI, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Paula Mendes Luz
- Laboratório de Pesquisa Clínica em HIV/AIDS (LapClin-AIDS), Instituto Nacional de Infectologia Evandro Chagas – INI, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Brenda Hoagland
- Laboratório de Pesquisa Clínica em HIV/AIDS (LapClin-AIDS), Instituto Nacional de Infectologia Evandro Chagas – INI, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Alessandro Farias
- Centro Especializado em Diagnóstico, Assistência e Pesquisa (CEDAP), Salvador, BA, Brazil
| | | | | | - Daila Alena Raenck Silva
- Centro de Testagem e Aconselhamento (CTA) Santa Marta, Secretaria Municipal de Saúde de Porto Alegre, RS, Brazil
| | - Marcos Benedetti
- Laboratório de Pesquisa Clínica em HIV/AIDS (LapClin-AIDS), Instituto Nacional de Infectologia Evandro Chagas – INI, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | | | - Beatriz Grinsztejn
- Laboratório de Pesquisa Clínica em HIV/AIDS (LapClin-AIDS), Instituto Nacional de Infectologia Evandro Chagas – INI, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Valdilea Gonçalves Veloso
- Laboratório de Pesquisa Clínica em HIV/AIDS (LapClin-AIDS), Instituto Nacional de Infectologia Evandro Chagas – INI, FIOCRUZ, Rio de Janeiro, RJ, Brazil
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O'Connell S, Queally M, Savage E, Murphy DM, Mc Carthy VJC. Preferences for support in managing symptoms of an asthma flare-up: a pilot study of a discrete choice experiment. J Asthma 2023; 60:393-402. [PMID: 35748303 DOI: 10.1080/02770903.2022.2054429] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Objective: Information on the preferences of people with asthma for support in managing a flare-up can inform service design which may facilitate appropriate help-seeking. To date, little is known about support preferences for managing a flare-up. The aim of this study was to develop and pilot a discrete choice experiment (DCE) to elicit the preferences of people with asthma with regards to support in managing a flare-up.Methods: Steps in developing the DCE included identification and selection of attributes and levels of the support services, construction of choice tasks, experimental design, construction of DCE instrument, and pretest (n=16) and pilot (n=38) studies of the DCE instrument. A multinomial logit model was used to examine the strength and direction of the six attributes in the pilot study.Results: Our results indicate that from a patient perspective, having a healthcare professional that listens to their concerns was the most valued attribute of support in asthma flare-up management. The other features of support valued by participants were timely access to consultation, a healthcare professional with knowledge of their patient history, a specialist doctor and face-to-face communication. Having a written action plan was the least valued attribute.Conclusions: Our findings suggest patient preference for a model of support in managing their symptoms which includes timely, face-to-face access to a healthcare professional that knows them and listens to their concerns. The findings of the pilot study need to be verified with a larger sample and using models to account for preference heterogeneity.
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Affiliation(s)
- Selena O'Connell
- School of Nursing & Midwifery, University College Cork, Cork, Ireland
| | - Michelle Queally
- Department of Enterprise and Technology, Galway Mayo Institute of Technology, Galway, Ireland
| | - Eileen Savage
- School of Nursing & Midwifery, University College Cork, Cork, Ireland
| | - Desmond M Murphy
- The Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland.,HRB Clinical Research Facility, University College Cork, Cork, Ireland
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Jiang S, Ren R, Gu Y, Jeet V, Liu P, Li S. Patient Preferences in Targeted Pharmacotherapy for Cancers: A Systematic Review of Discrete Choice Experiments. PHARMACOECONOMICS 2023; 41:43-57. [PMID: 36372823 PMCID: PMC9813042 DOI: 10.1007/s40273-022-01198-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/18/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Targeted pharmacotherapy has been increasingly applied in cancer treatment due to its breakthroughs. However, the unmet needs of cancer patients are still significant, highlighting the urgency to investigate patient preferences. It is unclear how patients deliberate their choices between different aspects of targeted therapy, including cost, efficacy, and adverse events. Since discrete choice experiments (DCEs) have been widely applied to patient preference elicitation, we reviewed DCEs on targeted therapy for different cancers. We also synthesized evidence on the factors influencing patients' choices and their willingness-to-pay (WTP) for survival when treated by targeted therapy. METHODS We searched databases, including PubMed, EMBASE and MEDLINE, up to August 16, 2022, supplemented by a reference screening. The attributes from the selected studies were categorized into three groups: outcomes, costs, and process. We also calculated the relative importance of attributes and WTP for survival whenever possible. The purpose, respondents, explanation, findings, significance (PREFS) checklist was used to evaluate the quality of the included DCE studies. RESULTS The review identified 34 eligible studies from 13 countries covering 14 cancers, such as breast, ovarian, kidney, prostate, and skin cancers. It also reveals a rising trend of DCEs on this topic, as most studies were published after 2018. We found that patients placed higher weights on the outcome (e.g., overall survival) and cost attributes than on process attributes. On average, patients were willing to pay $561 (95% confidence interval [CI]: $415-$758) and $716 (95% CI $524-$958) out-of-pocket for a 1-month increase in progression-free survival and overall survival, respectively. PREFS scores of the 34 studies ranged from 2 to 4, with a mean of 3.38 (SD: 0.65), suggesting a reasonable quality based on the checklist. However, most studies (n = 32, 94%) did not assess the impact of non-responses on the results. CONCLUSIONS This is the first systematic review focusing on patient preferences for targeted cancer therapy. We showcased novel approaches for evidence synthesis of DCE results, especially the attribute relative importance and WTP. The results may inform stakeholders about patient preferences toward targeted therapy and their WTP estimates. More studies with improved study design and quality are warranted to generate more robust evidence to assist decision making.
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Affiliation(s)
- Shan Jiang
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Ru Ren
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
- Center for Health Preference Research, Shandong University, Jinan, 250012, China
- Institute of Medical Sciences, The Second Hospital, Cheeloo College of Medicine, Shandong University, 247# Beiyuan Street, Jinan, 250033, China
| | - Yuanyuan Gu
- Macquarie University Centre for the Health Economy, Macquarie Business School & Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia.
| | - Varinder Jeet
- Macquarie University Centre for the Health Economy, Macquarie Business School & Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia
| | - Ping Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
- Center for Health Preference Research, Shandong University, Jinan, 250012, China
| | - Shunping Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
- Center for Health Preference Research, Shandong University, Jinan, 250012, China
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Jost M, Möser S. Salary, flexibility or career opportunity? A choice experiment on gender specific job preferences. FRONTIERS IN SOCIOLOGY 2023; 8:1154324. [PMID: 37139224 PMCID: PMC10150105 DOI: 10.3389/fsoc.2023.1154324] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/28/2023] [Indexed: 05/05/2023]
Abstract
Using the evaluation of hypothetical job offers in a discrete choice experiment, we analyse which characteristics of employment positions are relevant to men and women when deciding between job offers. Thereby, we investigate whether preferences for work arrangements are gender specific. The analysis shows that on average, women have a stronger preference for part-time work than men, and that the career prospect of a job is more important to men than to women. Furthermore, we use heterogeneity within genders to study whether gender specific preference patterns result from gendered considerations of family formation. We find that certain men and women, especially those who plan to have children and have traditional intentions about the division of labor in the household, evaluate work relationships more strongly according to gender roles than others. This analysis of hypothetical employment choices provides valuable insight into the preference structure of men and women, which proves to be heterogeneous within and between genders.
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Affiliation(s)
- Madlaina Jost
- Department of Sociology of Education, University of Bern, Bern, Switzerland
- School of Social Work, Bern University of Applied Sciences, Bern, Switzerland
| | - Sara Möser
- Department of Sociology of Education, University of Bern, Bern, Switzerland
- *Correspondence: Sara Möser
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Critiquing the evolution of maternity care preferences research: A systematic mixed studies review. Midwifery 2022; 111:103386. [DOI: 10.1016/j.midw.2022.103386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 05/09/2022] [Accepted: 05/23/2022] [Indexed: 11/22/2022]
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Broomfield G, Brown SD, Yap MB. Socioeconomic factors and parents' preferences for internet- and mobile-based parenting interventions to prevent youth mental health problems: A discrete choice experiment. Internet Interv 2022; 28:100522. [PMID: 35309756 PMCID: PMC8924632 DOI: 10.1016/j.invent.2022.100522] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 02/12/2022] [Accepted: 03/05/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The positive impact of parenting programs for youth mental health is undermined by difficulties engaging parents. Low engagement disproportionately impacts parents of lower-socioeconomic positions (SEPs). Internet- and mobile-based interventions hold potential for overcoming barriers to enrolment, but additional research is needed to understand how programs can appropriately meet the needs of parents across SEPs. Consumer preference methods such as discrete choice experiments may be valuable in this endeavour. METHOD A discrete choice experiment was used to determine the relative influence of modifiable program features on parents' intent to enrol. 329 Australian parents of children aged 0-18 repeatedly selected their preferred program from randomized sets of hypothetical programs in an online survey. Each hypothetical program was unique, varying across four program features: module duration, program platform, user control, and program cost. Cumulative link models were used to predict choices, with education, household income, and community advantage used as indicators of SEP. RESULTS Overall, parents preferred cheaper programs and briefer modules. Parents' preferences differed based on their socioeconomic challenges. Lower-income parents preferred briefer modules, cheaper programs and application-based programs compared to higher-income parents. Parents with less education preferred briefer modules and a predefined module order. Parents living in areas of less advantage preferred website-based programs, user choice of module order, and more expensive programs. CONCLUSIONS This study offers program developers evidence-based strategies for tailoring internet- and mobile-based parenting interventions to increase lower-SEP parent enrolment. Findings also highlight the importance of considering parents' socioeconomic challenges to ensure programs do not perpetuate existing mental health inequalities, as "one-size-fits-all" approaches are likely insufficient for reaching lower-SEP parents.
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Affiliation(s)
- Grace Broomfield
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Scott D. Brown
- School of Psychological Sciences, The University of Newcastle, Callaghan, Australia
| | - Marie B.H. Yap
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia,Corresponding author at: Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Clayton, Melbourne 3800, Australia.
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Wang C, Gu Y, Zhao L, Zhang Y, Zhou R, Gu M, Wang L. Stated preferences for family doctor contract services: a survey of the rural elderly in Anhui Province, China. BMJ Open 2022; 12:e053277. [PMID: 35241465 PMCID: PMC8896044 DOI: 10.1136/bmjopen-2021-053277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE A number of factors contribute to the utilisation of family doctor contract services (FDCS) in China. This study aims to measure the preferences of the elderly for the FDCS and identify the key factors (and their relative importance) that may guide policymakers in more accurately providing the FDCS. PARTICIPANTS AND METHODS A discrete choice experiment was performed to elicit the preferences for FDCS among the rural elderly in China. Attributes and levels were established based on qualitative methods. Four attributes were included: service type, service package, physician's reputation and annual contract costs. A D-efficient design was used to create a set of profiles that represented FDCS. The survey was conducted face to face using a sample of participants aged 60 and above in rural areas of Anhui Province. The data were analysed using a latent class logit (LCL) model. RESULTS A total of 545 valid questionnaires were included in the analysis. The average age of the participants was 69.44 (SD 5.80). Two latent classes were identified with the LCL model. All four attributes proved statistically significant at the level of both the population mean and the two classes. The rural elderly showed a preference for FDCS with a relatively good reputation, lower annual contract costs, the basic service with the add-on of chronic disease service and home visit. Age, gender, education, self-reported health status and the number of chronic diseases were found to be associated with latent class membership. CONCLUSION In this study, the physician's reputation had the largest impact on the rural elderly's choice of FDCS. Policy recommendations included the need to strengthen family doctor team training, devote greater attention to improving the family doctor's medical skills and service approaches, and increased FDCS efficiency for the care of the rural elderly.
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Affiliation(s)
- Cuilian Wang
- School of Health Service and Management, Anhui Medical University, Hefei, Anhui, China
- Stomatologic Hospital and College, Anhui Medical University, Hefei, Anhui, China
| | - Yuanyuan Gu
- Centre for the Health Economy, Macquarie University, Sydney, New South Wales, Australia
| | - Linhai Zhao
- School of Health Service and Management, Anhui Medical University, Hefei, Anhui, China
| | - Youran Zhang
- School of Health Service and Management, Anhui Medical University, Hefei, Anhui, China
| | - Rui Zhou
- School of Health Service and Management, Anhui Medical University, Hefei, Anhui, China
| | - Megan Gu
- Centre for the Health Economy, Macquarie University, Sydney, New South Wales, Australia
| | - Lidan Wang
- School of Health Service and Management, Anhui Medical University, Hefei, Anhui, China
- Center for Health Policy Research, Anhui Medical University, Hefei, Anhui, China
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23
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Phillips EA, Himmler S, Schreyögg J. Preferences of psychotherapists for blended care in Germany: a discrete choice experiment. BMC Psychiatry 2022; 22:112. [PMID: 35151294 PMCID: PMC8841060 DOI: 10.1186/s12888-022-03765-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 02/02/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Digital treatment formats are emerging within mental health care. Evidence suggests that mental health care providers and recipients prefer a combination of digital and traditional elements within psychotherapy treatment formats, also called blended care (BC), over standalone digital formats. We examined the attitudes and preferences of licensed psychotherapists in Germany regarding such BC applications. METHODS We fielded a survey among psychotherapists, including questions about attitudes, previous experiences, and expectations regarding BC, as well as a discrete choice experiment. Attributes for the experiment were developed using a stepwise qualitative approach. A Bayesian D-efficient design was used to generate the choice tasks. The choice data were analyzed by applying mixed logit models. RESULTS The survey was completed by 200 psychotherapists. Attitudes towards BC were mainly positive, with strong reported intentions to use BC formats. In the choice experiment, recommendation from a professional society for a BC online component was the most important characteristic. Greater effectiveness and a larger share of face-to-face vs. online time were also desired features, while a financial incentive to use BC was less relevant.
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Affiliation(s)
- Elena A. Phillips
- grid.9026.d0000 0001 2287 2617Hamburg Center for Health Economics, University of Hamburg, Esplanade 36, 20354 Hamburg, Germany
| | - Sebastian Himmler
- Erasmus School of Health Policy & Management Health Economics, Burg. Oudlaan 50, 3062 Rotterdam, PA Netherlands
| | - Jonas Schreyögg
- grid.9026.d0000 0001 2287 2617Hamburg Center for Health Economics, University of Hamburg, Esplanade 36, 20354 Hamburg, Germany
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24
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Wang K, Wong ELY, Cheung AWL, Yau PSY, Chung VCH, Wong CHL, Dong D, Wong SYS, Yeoh EK. Influence of Vaccination Characteristics on COVID-19 Vaccine Acceptance Among Working-Age People in Hong Kong, China: A Discrete Choice Experiment. Front Public Health 2021; 9:793533. [PMID: 34957038 PMCID: PMC8702724 DOI: 10.3389/fpubh.2021.793533] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 11/15/2021] [Indexed: 01/10/2023] Open
Abstract
Background: Along with individual-level factors, vaccination-related characteristics are important in understanding COVID-19 vaccine hesitancy. This study aimed to determine the influence of these characteristics on vaccine acceptance to formulate promotion strategies after considering differences among respondents with different characteristics. Methods: An online discrete choice experiment was conducted among people aged 18–64 years in Hong Kong, China, from 26 to 28 February 2021. Respondents were asked to make choices regarding hypothetical vaccination programmes described by vaccination-related characteristics—the attributes derived from a prior individual interview. Subgroup analysis was performed to identify the differences in vaccination-related characteristics among respondents with different personal characteristics. Results: A total of 1,773 respondents provided valid responses. The vaccine efficacy and brand were the most important factors affecting acceptance, followed by the exemption of quarantine for vaccinated travelers, safety, venue for vaccination, vaccine uptake of people in their lives, and recommendations by general physicians or government. Frequent exposure to vaccination information on social media has been associated with increasing vaccine refusal. Substantial preference heterogeneity for the attributes was found among people of different ages, incomes, chronic conditions, and previous acceptance of influenza vaccines. Conclusion: The findings provided evidence to formulate interventions to promote vaccine uptake, including the provision of vaccination at housing estate or workplaces, involvement of general physicians and interpersonal communication in vaccine promotion and information dissemination, and exemption of quarantine for vaccinated people. Moreover, social media is a significant information channel that cannot be neglected in the dissemination of official information.
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Affiliation(s)
- Kailu Wang
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Eliza Lai-Yi Wong
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Annie Wai-Ling Cheung
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Peter Sen-Yung Yau
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Vincent Chi-Ho Chung
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Charlene Hoi-Lam Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Dong Dong
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Samuel Yeung-Shan Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Eng-Kiong Yeoh
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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25
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Houwen T, Vugts MAP, Lansink KWW, Theeuwes HP, Neequaye N, Beerekamp MSH, Joosen MCW, de Jongh MAC. Developing mHealth to the Context and Valuation of Injured Patients and Professionals in Hospital Trauma Care: Qualitative and Quantitative Formative Evaluations (Preprint). JMIR Hum Factors 2021; 9:e35342. [PMID: 35723928 PMCID: PMC9254041 DOI: 10.2196/35342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 05/10/2022] [Accepted: 05/14/2022] [Indexed: 11/30/2022] Open
Abstract
Background Trauma care faces challenges to innovating their services, such as with mobile health (mHealth) app, to improve the quality of care and patients’ health experience. Systematic needs inquiries and collaborations with professional and patient end users are highly recommended to develop and prepare future implementations of such innovations. Objective This study aimed to develop a trauma mHealth app for patient information and support in accordance with the Center for eHealth Research and Disease Management road map and describe experiences of unmet information and support needs among injured patients with trauma, barriers to and facilitators of the provision of information and support among trauma care professionals, and drivers of value of an mHealth app in patients with trauma and trauma care professionals. Methods Formative evaluations were conducted using quantitative and qualitative methods. Ten semistructured interviews with patients with trauma and a focus group with 4 trauma care professionals were conducted for contextual inquiry and value specification. User requirements and value drivers were applied in prototyping. Furthermore, a complementary quantitative discrete choice experiment (DCE) was conducted with 109 Dutch trauma surgeons, which enabled triangulation on value specification results. In the DCE, preferences were stated for hypothetical mHealth products with various attributes. Panel data from the DCE were analyzed using conditional and mixed logit models. Results Patients disclosed a need for more psychosocial support and easy access to more extensive information on their injury, its consequences, and future prospects. Health care professionals designated workload as an essential issue; a digital solution should not require additional time. The conditional logit model of DCE results suggested that access to patient app data through electronic medical record integration (odds ratio [OR] 3.3, 95% CI 2.55-4.34; P<.001) or a web viewer (OR 2.3, 95% CI 1.64-3.31; P<.001) was considered the most important for an mHealth solution by surgeons, followed by the inclusion of periodic self-measurements (OR 2, 95% CI 1.64-2.46; P<.001), the local adjustment of patient information (OR 1.8, 95% CI 1.42-2.33; P<.001), local hospital identification (OR 1.7, 95% CI 1.31-2.10; P<.001), complication detection (OR 1.5, 95% CI 1.21-1.84; P<.001), and the personalization of rehabilitation through artificial intelligence (OR 1.4, 95% CI 1.13-1.62; P=.001). Conclusions In the context of trauma care, end users have many requirements for an mHealth solution that addresses psychosocial functioning; dependable information; and, possibly, a prediction of how a patient’s recovery trajectory is evolving. A structured development approach provided insights into value drivers and facilitated mHealth prototype enhancement. The findings imply that iterative development should move on from simple and easily implementable mHealth solutions to those that are suitable for broader innovations of care pathways that most—but plausibly not yet all—end users in trauma care will value. This study could inspire the trauma care community.
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Affiliation(s)
- Thymen Houwen
- Network Emergency Care Brabant, Elisabeth-TweeSteden Ziekenhuis, Tilburg, Netherlands
| | - Miel A P Vugts
- Tranzo Scientific Centre for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
- Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
| | - Koen W W Lansink
- Department of Trauma Surgery, Elisabeth-TweeSteden Ziekenhuis, Tilburg, Netherlands
| | - Hilco P Theeuwes
- Department of Trauma Surgery, Elisabeth-TweeSteden Ziekenhuis, Tilburg, Netherlands
| | - Nicky Neequaye
- Network Emergency Care Brabant, Elisabeth-TweeSteden Ziekenhuis, Tilburg, Netherlands
| | | | - Margot C W Joosen
- Tranzo Scientific Centre for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - Mariska A C de Jongh
- Network Emergency Care Brabant, Elisabeth-TweeSteden Ziekenhuis, Tilburg, Netherlands
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26
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Frimpong JA, Helleringer S. Strategies to increase downloads of COVID-19 exposure notification apps: A discrete choice experiment. PLoS One 2021; 16:e0258945. [PMID: 34723981 PMCID: PMC8559927 DOI: 10.1371/journal.pone.0258945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 10/10/2021] [Indexed: 11/18/2022] Open
Abstract
Exposure notification apps have been developed to assist in notifying individuals of recent exposures to SARS-CoV-2. However, in several countries, such apps have had limited uptake. We assessed whether strategies to increase downloads of exposure notification apps should emphasize improving the accuracy of the apps in recording contacts and exposures, strengthening privacy protections and/or offering financial incentives to potential users. In a discrete choice experiment with potential app users in the US, financial incentives were more than twice as important in decision-making about app downloads, than privacy protections, and app accuracy. The probability that a potential user would download an exposure notification app increased by 40% when offered a $100 reward to download (relative to a reference scenario in which the app is free). Financial incentives might help exposure notification apps reach uptake levels that improve the effectiveness of contact tracing programs and ultimately enhance efforts to control SARS-CoV-2. Rapid, pragmatic trials of financial incentives for app downloads in real-life settings are warranted.
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Affiliation(s)
- Jemima A. Frimpong
- Division of Social Science, Program in Social Research and Public Policy, New York University–Abu Dhabi (UAE), Abu Dhabi, United Arab Emirates
- Carey Business School, Johns Hopkins University, Baltimore, MD, United States of America
- * E-mail:
| | - Stéphane Helleringer
- Division of Social Science, Program in Social Research and Public Policy, New York University–Abu Dhabi (UAE), Abu Dhabi, United Arab Emirates
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27
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Sakowsky RA. Disentangling the welfarism/extra-welfarism distinction: Towards a more fine-grained categorization. HEALTH ECONOMICS 2021; 30:2307-2311. [PMID: 34216077 DOI: 10.1002/hec.4382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 06/08/2021] [Accepted: 06/18/2021] [Indexed: 06/13/2023]
Abstract
In health economics, the distinction between welfarism and extra-welfarism has been employed to discuss various epistemological and normative differences between health evaluation approaches. However, a clear consensus on the definition of either welfarism, extra-welfarism, or the differences between the two sets of approaches has not emerged. I propose an alternative set of distinctions that allows for a more fine-grained categorization of health evaluation approaches. This categorization focuses on five dimensions: (1) the maximand of an evaluation approach, (2) its sensitivity toward normative concerns that defy compensation, (3) its position on which groups of individuals or collective entities act as sources of values, (4) its sensitivity to changes of mind, and (5) the inclusion of process-external values.
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Affiliation(s)
- Ruben Andreas Sakowsky
- Department of Medical Ethics and History of Medicine, University Medical Center Göttingen, Göttingen, Germany
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28
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Edmunds K, Wall L, Brown S, Searles A, Shakeshaft AP, Doran CM. Exploring Community-Based Options for Reducing Youth Crime. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105097. [PMID: 34065813 PMCID: PMC8150417 DOI: 10.3390/ijerph18105097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 04/30/2021] [Accepted: 05/06/2021] [Indexed: 12/24/2022]
Abstract
BackTrack is a multi-component, community-based intervention designed to build capacity amongst 14–17-year-old high risk young people. The aim of the current study seeks to explore community value and preferences for reducing youth crime and improving community safety using BackTrack in a rural setting in Armidale, New South Wales, Australia. The study design used discrete choice experiments (DCEs), designed in accordance with the 10-item checklist outlined by the International Society for Pharmacoeconomics and Outcomes Research. The DCE was pilot tested on 43 participants to test feasibility and comprehension. A revised version of the survey was subsequently completed by 282 people over a 12-day period between 30 May 2016 and 10 June 2016, representing a survey response rate of 35%. Ninety per cent of respondents were residents of Armidale, the local rural town where BackTrack was implemented. The DCE generated results that consistently demonstrated a preference for social programs to address youth crime and community safety in the Armidale area. Respondents chose BackTrack over Greater Police Presence 75% of the time with an annual benefit of Australian dollars (AUD) 150 per household, equivalent to a community benefit of AUD 2.04 million. This study estimates a strong community preference for BackTrack relative to more policing (a community willing to pay equivalent to AUD 2.04 million) highlighting the clear value of including community preferences when evaluating community-based programs for high-risk young people.
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Affiliation(s)
- Kim Edmunds
- Centre for Applied Health Economics, Griffith University, Nathan, QLD 4111, Australia;
| | - Laura Wall
- School of Psychology, University of Newcastle, Callaghan, NSW 2308, Australia; (L.W.); (S.B.)
| | - Scott Brown
- School of Psychology, University of Newcastle, Callaghan, NSW 2308, Australia; (L.W.); (S.B.)
| | - Andrew Searles
- Health Research Economics, Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW 2305, Australia;
| | - Anthony P. Shakeshaft
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Randwick, NSW 2502, Australia;
| | - Christopher M. Doran
- Cluster for Resilience and Wellbeing, Appleton Institute, Central Queensland University, Brisbane, QLD 4000, Australia
- Correspondence: ; Tel.: +61-412-935-084
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Torbica A, Rognoni C, Tarricone R. Investigating Patients' Preferences to Inform Drug Development Decisions: Novel Insights from a Discrete Choice Experiment in Migraine. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094916. [PMID: 34063035 PMCID: PMC8124202 DOI: 10.3390/ijerph18094916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 04/29/2021] [Accepted: 05/02/2021] [Indexed: 11/25/2022]
Abstract
There is limited evidence on the scope and overall benefit of patient-centred drug development decisions. The present study assessed patients’ preferences for the characteristics of an ideal migraine treatment through a discrete choice experiment in order to inform decision-making and drug development processes. We investigated the preferences according to five treatment attributes identified from a systematic literature review and two focus group elicitations. The heterogeneity of preferences was also investigated. Overall, the respondents considered the presence of adverse events, duration of treatment effect, reduction of symptom intensity, speed of effect and cost born by the patient as the most relevant treatment features. As expected, the patients preferred treatments with lower levels of adverse events and costs and treatments with greater speed, duration of treatment effect and effectiveness in reducing symptom intensity. There was significant preference heterogeneity only for the presence of adverse events. Compared to men, women had significantly higher preferences for quicker treatment effect and limited adverse events and reported higher preferences for costly treatments. The results of our survey help address research and development strategies in the pharmaceutical industry and public policy regarding treatments that are clinically effective and responsive to the needs expressed by patients.
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Affiliation(s)
- Aleksandra Torbica
- CERGAS (Centre for Research on Health and Social Care Management), SDA Bocconi School of Management, Bocconi University, 20136 Milan, Italy; (A.T.); (R.T.)
- Department of Social and Political Sciences, Bocconi University, 20136 Milan, Italy
| | - Carla Rognoni
- CERGAS (Centre for Research on Health and Social Care Management), SDA Bocconi School of Management, Bocconi University, 20136 Milan, Italy; (A.T.); (R.T.)
- Correspondence:
| | - Rosanna Tarricone
- CERGAS (Centre for Research on Health and Social Care Management), SDA Bocconi School of Management, Bocconi University, 20136 Milan, Italy; (A.T.); (R.T.)
- Department of Social and Political Sciences, Bocconi University, 20136 Milan, Italy
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30
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Phillips EA, Himmler SF, Schreyögg J. Preferences for e-Mental Health Interventions in Germany: A Discrete Choice Experiment. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:421-430. [PMID: 33641777 DOI: 10.1016/j.jval.2020.09.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 08/11/2020] [Accepted: 09/30/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Recent evidence suggests that e-mental health interventions can be effective at improving mental health but that there is still a notable hesitation among patients to use them. Previous research has revealed that they are perceived by patients as being less helpful than face-to-face psychotherapy. The reasons for this unfavorable perception are, however, not yet well understood. The aim of our study was to address this question by eliciting preferences for individual components of e-mental health interventions in a discrete choice experiment. METHODS Using a stepwise qualitative approach, we developed the following 5 attributes of eMHIs: introductory training, human contact, peer support, proven effectiveness, content delivery, and price. Additionally, we asked questions about respondents' demographics, attitudes, and previous experience of traditional psychotherapy, as well as their distress level. RESULTS A total of 1984 respondents completed the survey. Using mixed logit models, we found that personal contact with a psychotherapist in blended care, proven effectiveness, and low price were highly valued by participants. Participants were indifferent toward the mode of content delivery but showed a slight preference for introductory training via phone, as well as for peer support via online forum alongside coach-led group meetings on site. DISCUSSION Our results suggest a clear preference for blended care that includes face-to-face contact with a psychotherapist. This preference remained stable irrespective of sociodemographics, previous experience of psychotherapy, distress level, and the 2 context scenarios used in our discrete choice experiment. Further investigations looking at the potential benefits and risks of blended care are needed.
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Affiliation(s)
- Elena A Phillips
- Hamburg Center for Health Economics, University of Hamburg, Hamburg, Germany.
| | - Sebastian F Himmler
- Erasmus School of Health Policy & Management Health Economics, Rotterdam, The Netherlands
| | - Jonas Schreyögg
- Hamburg Center for Health Economics, University of Hamburg, Hamburg, Germany
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31
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Russo S, Monzani D, Pinto CA, Vergani L, Marton G, Falahee M, Simons G, Whichello C, Kihlbom U, Pravettoni G. Taking into Account Patient Preferences: A Consensus Study on the Assessment of Psychological Dimensions Within Patient Preference Studies. Patient Prefer Adherence 2021; 15:1331-1345. [PMID: 34177261 PMCID: PMC8219660 DOI: 10.2147/ppa.s261615] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 03/23/2021] [Indexed: 11/23/2022] Open
Abstract
Patient preferences are gaining recognition among key stakeholders involved in benefit-risk decision-making along the medical product lifecycle. However, one of the main challenges of integrating patient preferences in benefit-risk decision-making is understanding differences in patient preference, which may be attributable to clinical characteristics (eg age, medical history) or psychosocial factors. Measuring the latter may provide valuable information to decision-makers but there is limited guidance regarding which psychological dimensions may influence patient preferences and which psychological instruments should be considered for inclusion in patient preference studies. This paper aims to provide such guidance by advancing evidence and consensus-based recommendations and considerations. Findings of a recent systematic review on psychological constructs having an impact on patients' preferences and health-related decisions were expanded with input from an expert group (n = 11). These data were then used as the basis for final recommendations developed through two rounds of formal evaluation via an online Delphi consensus process involving international experts in the field of psychology, medical decision-making, and risk communication (n = 27). Three classes of recommendations emerged. Eleven psychological constructs reached consensus to be recommended for inclusion with the strongest consensus existing for health literacy, numeracy, illness perception and treatment-related beliefs. We also proposed a set of descriptive and checklist criteria to appraise available psychological measures to assist researchers and other stakeholders in including psychological assessment when planning patient preference studies. These recommendations can guide researchers and other stakeholders when designing and interpreting patient preference studies with a potential high impact in clinical practice and medical product benefit-risk decision-making processes.
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Affiliation(s)
- Selena Russo
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Discipline of Paediatrics, School of Women’s and Children’s Health, The University of New South Wales, Kensington, NSW, Australia
- Correspondence: Selena Russo Department of Medicine and Surgery, University of Milano, Bicocca, via Cadore 48, Monza (MB), 20052, Italy Email
| | - Dario Monzani
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Cathy Anne Pinto
- Department of Pharmacoepidemiology, Merck & Co., Inc., Kenilworth, NJ, USA
| | - Laura Vergani
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Giulia Marton
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Marie Falahee
- Rheumatology Research Group, Institute of Inflammation and Ageing (IIA), University of Birmingham, Birmingham, UK
| | - Gwenda Simons
- Rheumatology Research Group, Institute of Inflammation and Ageing (IIA), University of Birmingham, Birmingham, UK
| | - Chiara Whichello
- Erasmus School of Health Policy & Management (ESHPM) and Erasmus Choice Modelling Centre (ECMC), Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Ulrik Kihlbom
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
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Webb EJD, Stamp E, Collinson M, Farrin AJ, Stevens J, Burton W, Rutter H, Schofield H, Bryant M. Measuring commissioners' willingness-to-pay for community based childhood obesity prevention programmes using a discrete choice experiment. BMC Public Health 2020; 20:1535. [PMID: 33046078 PMCID: PMC7549208 DOI: 10.1186/s12889-020-09576-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 09/21/2020] [Indexed: 11/10/2022] Open
Abstract
Background In the UK, rates of childhood obesity remain high. Community based programmes for child obesity prevention are available to be commissioned by local authorities. However, there is a lack of evidence regarding how programmes are commissioned and which attributes of programmes are valued most by commissioners. The aim of this study was to determine the factors that decision-makers prioritise when commissioning programmes that target childhood obesity prevention. Methods An online discrete choice experiment (DCE) was used to survey commissioners and decision makers in the UK to assess their willingness-to-pay for childhood obesity programmes. Results A total of 64 commissioners and other decision makers completed the DCE. The impact of programmes on behavioural outcomes was prioritised, with participants willing to pay an extra £16,600/year if average daily fruit and vegetable intake increased for each child by one additional portion. Participants also prioritised programmes that had greater number of parents fully completing them, and were willing to pay an extra £4810/year for every additional parent completing a programme. The number of parents enrolling in a programme (holding the number completing fixed) and hours of staff time required did not significantly influence choices. Conclusions Emphasis on high programme completion rates and success increasing children’s fruit and vegetable intake has potential to increase commissioning of community based obesity prevention programmes.
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Affiliation(s)
- Edward J D Webb
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
| | - Elizabeth Stamp
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Michelle Collinson
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Amanda J Farrin
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - June Stevens
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA.,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
| | - Wendy Burton
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Holly Schofield
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Maria Bryant
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK.,Department of Health Sciences and the Hull York Medical School, University of York, Heslington, York, UK
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Su J, Li N, Joshi N, Ng X, Botteman M, Shah R, Jain N, Lyn N, Preblick R. Patient and caregiver preferences for haemophilia A treatments: A discrete choice experiment. Haemophilia 2020; 26:e291-e299. [DOI: 10.1111/hae.14137] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 06/23/2020] [Accepted: 08/06/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Jun Su
- Sanofi Genzyme Cambridge MA USA
| | | | - Namita Joshi
- Pharmerit, an OPEN Health Company Bethesda MD USA
| | - Xinyi Ng
- Pharmerit, an OPEN Health Company Bethesda MD USA
| | | | - Rachel Shah
- Pharmerit, an OPEN Health Company Bethesda MD USA
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Tully MP, Bernsten C, Aitken M, Vass C. Public preferences regarding data linkage for research: a discrete choice experiment comparing Scotland and Sweden. BMC Med Inform Decis Mak 2020; 20:109. [PMID: 32546147 PMCID: PMC7298855 DOI: 10.1186/s12911-020-01139-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 05/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There are increasing examples of linking data on healthcare resource use and patient outcomes from different sectors of health and social care systems. Linked data are generally anonymised, meaning in most jurisdictions there are no legal restrictions to their use in research conducted by public or private organisations. Secondary use of anonymised linked data is contentious in some jurisdictions but other jurisdictions are known for their use of linked data. The publics' perceptions of the acceptability of using linked data is likely to depend on a number of factors. This study aimed to quantify the preferences of the public to understand the factors that affected views about types of linked data and its use in two jurisdictions. METHOD An online discrete choice experiment (DCE) previously conducted in Scotland was adapted and replicated in Sweden. The DCE was designed, comprising five attributes, to elicit the preferences from a representative sample of the public in both jurisdictions. The five attributes (number of levels) were: type of researcher using linked data (four); type of data being linked (four); purpose of the research (three); use of profit from using linked data (four); who oversees the research (four). Each DCE contained 6 choice-sets asking respondents to select their preferred option from two scenarios or state neither were acceptable. Background questions included socio-demographics. DCE data were analysed using conditional and heteroskedastic conditional logit models to create forecasts of acceptability. RESULTS The study sample comprised members of the public living in Scotland (n = 1004) and Sweden (n = 974). All five attributes were important in driving respondents' choices. Swedish and Scottish preferences were mostly homogenous with the exception of 'who oversees the research using linked data', which had relatively less impact on the choices observed from Scotland. For a defined 'typical' linked data scenario, the probability (on average) of acceptance was 85.7% in Sweden and 82.4% in Scotland. CONCLUSION This study suggests that the public living in Scotland and Sweden are open to using anonymised linked data in certain scenarios for research purposes but some caution is advisable if the anonymised linked data joins health to non-health data.
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Affiliation(s)
- Mary P. Tully
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Cecilia Bernsten
- Department of Public Health and Caring Sciences, Health and Medical Research, University of Uppsala, Uppsala, Sweden
| | - Mhairi Aitken
- Newcastle University Business School, Newcastle University, Newcastle upon Tyne, UK
| | - Caroline Vass
- Division of Population Health, Health Services Research & Primary Care, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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Is India Ready for Alt-Meat? Preferences and Willingness to Pay for Meat Alternatives. SUSTAINABILITY 2020. [DOI: 10.3390/su12114377] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Little is known about the consumer preferences of next-generation plant-based and cell-based meat alternatives, two food technologies that offer a demand-side solution to the environmental, nutritional, and other societal concerns associated with animal-intensive agriculture. To address this gap, this paper estimates consumers’ willingness to pay for four sources of protein (conventional meat, plant-based meat, cell-based meat, and chickpeas) in a developing country with rising demand for meat—India. A latent class model of a discrete choice experiment conducted in Mumbai identifies four heterogeneous segments in the Indian market. Aggregating across all four segments, respondents are willing to pay a premium for plant-based meat and a smaller premium for cell-based meat over the price of conventional meat. However, our main findings show that these premiums strongly differ across the four consumer-class segments. The results offer important insights into future price points and policy options that might make these meat alternatives commercially successful, and therefore, a viable option in addressing societal concerns.
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Yihdego M, Amogne A, Desta S, Choi Y, Shiferaw S, Seme A, Liu L, Helleringer S. Improving the demand for birth registration: a discrete choice experiment in Ethiopia. BMJ Glob Health 2020; 5:e002209. [PMID: 32444362 PMCID: PMC7247413 DOI: 10.1136/bmjgh-2019-002209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 03/18/2020] [Accepted: 04/07/2020] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Birth registration remains limited in most low and middle-income countries. We investigated which characteristics of birth registration facilities might determine caregivers' decisions to register children in Ethiopia. METHODS We conducted a discrete choice experiment in randomly selected households in Addis Ababa and the Southern Nations, Nationalities, and People's Region. We interviewed caregivers of children 0-5 years old. We asked participants to make eight choices between pairs of hypothetical registration facilities. These facilities were characterised by six attributes selected through a literature review and consultations with local stakeholders. Levels of these attributes were assigned at random using a fractional design. We analysed the choice data using mixed logit models that account for heterogeneity in preferences across respondents. We calculated respondents' willingness to pay to access registration facilities with specific attributes. We analysed all data separately by place of residence (urban vs rural). RESULTS Seven hundred and five respondents made 5614 choices. They exhibited preferences for registration facilities that charged lower fees for birth certificates, that required shorter waiting time to complete procedures and that were located closer to their residence. Respondents preferred registration facilities that were open on weekends, and where they could complete procedures in a single visit. In urban areas, respondents also favoured registration facilities that remained open for extended hours on weekdays, and where the presence of only one of the parents was required for registration. There was significant heterogeneity between respondents in the utility derived from several attributes of registration facilities. Willingness to pay for access to registration facilities with particular attributes was larger in urban than rural areas. CONCLUSION In these regions of Ethiopia, changes to the operating schedule of registration facilities and to application procedures might help improve registration rates. Discrete choice experiments can help orient initiatives aimed at improving birth registration.
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Affiliation(s)
- Mahari Yihdego
- PMA Ethiopia Project, Addis Ababa University, Addis Ababa, Addis Ababa, Ethiopia
| | - Ayanaw Amogne
- PMA Ethiopia Project, Addis Ababa University, Addis Ababa, Addis Ababa, Ethiopia
| | - Selamawit Desta
- School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Solomon Shiferaw
- Department of Reproductive Health and Health Service Management, Addis Ababa University, Addis Ababa, Ethiopia
| | - Assefa Seme
- Department of Reproductive Health and Health Service Management, Addis Ababa University, Addis Ababa, Ethiopia
| | - Li Liu
- School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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Protiere C, Arnold M, Fiorentino M, Fressard L, Lelièvre JD, Mimi M, Raffi F, Mora M, Meyer L, Sagaon‐Teyssier L, Zucman D, Préau M, Lambotte O, Spire B, Suzan‐Monti M. Differences in HIV cure clinical trial preferences of French people living with HIV and physicians in the ANRS-APSEC study: a discrete choice experiment. J Int AIDS Soc 2020; 23:e25443. [PMID: 32077248 PMCID: PMC7048214 DOI: 10.1002/jia2.25443] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 12/04/2019] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Despite the advent of HIV cure-related clinical trials (HCRCT) for people living with HIV (PLWH), the risks and uncertainty involved raise ethical issues. Although research has provided insights into the levers and barriers to PLWH and physicians' participation in these trials, no information exists about stakeholders' preferences for HCRCT attributes, about the different ways PLWH and physicians value future HCRCT, or about how personal characteristics affect these preferences. The results from the present study will inform researchers' decisions about the most suitable HCRCT strategies to implement, and help them ensure ethical recruitment and well-designed informed consent. METHODS Between October 2016 and March 2017, a discrete choice experiment was conducted among 195 virally controlled PLWH and 160 physicians from 24 French HIV centres. Profiles within each group, based on individual characteristics, were obtained using hierarchical clustering. Trade-offs between five HCRCT attributes (trial duration, consultation frequency, moderate (digestive disorders, flu-type syndrome, fatigue) and severe (allergy, infections, risk of cancer) side effects (SE), outcomes) and utilities associated with four HCRCT candidates (latency reactivation, immunotherapy, gene therapy and a combination of latency reactivation and immunotherapy), were estimated using a mixed logit model. RESULTS Apart from severe SE - the most decisive attribute in both groups - PLWH and physicians made different trade-offs between HCRCT attributes, the latter being more concerned about outcomes, the former about the burden of participation (consultation frequency and moderate SE). These different trades-offs resulted in differences in preferences regarding the four candidate HCRCT. PLWH significantly preferred immunotherapy, whereas physicians preferred immunotherapy and combined therapy. Despite the heterogeneity of characteristics within the PLWH and physician profiles, results show some homogeneity in trade-offs and utilities regarding HCRCT. CONCLUSIONS Severe SE, not outcomes, was the most decisive attribute determining future HCRCT participation. Particular attention should be paid to providing clear information, in particular on severe SE, to potential participants. Immunotherapy would appear to be the best HCRCT candidate for both PLWH and physicians. However, if the risk of cancer could be avoided, gene therapy would become the preferred strategy for the latter and the second choice for the former.
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Affiliation(s)
- Christel Protiere
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information MédicaleAix Marseille UnivMarseilleFrance
- ORS PACAObservatoire régional de la santé Provence‐Alpes‐Côte d'AzurMarseilleFrance
| | | | - Marion Fiorentino
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information MédicaleAix Marseille UnivMarseilleFrance
- ORS PACAObservatoire régional de la santé Provence‐Alpes‐Côte d'AzurMarseilleFrance
| | - Lisa Fressard
- ORS PACAObservatoire régional de la santé Provence‐Alpes‐Côte d'AzurMarseilleFrance
| | - Jean D Lelièvre
- INSERMCréteilFrance
- Faculté de médecineUniversité Paris EstCréteilFrance
- Vaccine Research InstituteCréteilFrance
| | - Mohamed Mimi
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information MédicaleAix Marseille UnivMarseilleFrance
- ORS PACAObservatoire régional de la santé Provence‐Alpes‐Côte d'AzurMarseilleFrance
| | - François Raffi
- Department of Infectious DiseasesHotel‐Dieu Hospital ‐ INSERM CIC 1413Nantes University HospitalNantesFrance
| | - Marion Mora
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information MédicaleAix Marseille UnivMarseilleFrance
- ORS PACAObservatoire régional de la santé Provence‐Alpes‐Côte d'AzurMarseilleFrance
| | - Laurence Meyer
- Département d'épidémiologie, INSERM, U1018Université Paris‐Sud 11AP‐HPHôpital de BicêtreLe Kremlin‐BicêtreFrance
| | - Luis Sagaon‐Teyssier
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information MédicaleAix Marseille UnivMarseilleFrance
- ORS PACAObservatoire régional de la santé Provence‐Alpes‐Côte d'AzurMarseilleFrance
| | - David Zucman
- Hôpital Foch, service de médecine interneSuresnesFrance
| | | | - Olivier Lambotte
- Assistance Publique ‐ Hôpitaux de ParisHôpital BicêtreService de Médecine Interne et Immunologie cliniqueLe Kremlin‐BicêtreFrance
- Immunology of Viral Infections and Autoimmune DiseasesINSERM, U1184Le Kremlin‐BicêtreFrance
- UMR 1184Université Paris SudLe Kremlin‐BicêtreFrance
- CEADSV/iMETIIDMITFontenay‐aux‐RosesFrance
| | - Bruno Spire
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information MédicaleAix Marseille UnivMarseilleFrance
- ORS PACAObservatoire régional de la santé Provence‐Alpes‐Côte d'AzurMarseilleFrance
| | - Marie Suzan‐Monti
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information MédicaleAix Marseille UnivMarseilleFrance
- ORS PACAObservatoire régional de la santé Provence‐Alpes‐Côte d'AzurMarseilleFrance
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Marsh K, Hawken N, Brookes E, Kuehn C, Liden B. Patient-centered benefit-risk analysis of transcatheter aortic valve replacement. F1000Res 2019; 8:394. [PMID: 31249679 PMCID: PMC6544076 DOI: 10.12688/f1000research.18796.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/01/2021] [Indexed: 07/30/2023] Open
Abstract
Background: Aortic stenosis (AS) treatments include surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR). Choosing between SAVR and TAVR requires patients to trade-off benefits and risks. The objective of this research was to determine which TAVR and SAVR outcomes patients consider important, collect quantitative data about how patients weigh benefits and risks, and evaluate patients' preferences for SAVR or TAVR. Methods: Patients were recruited from advocacy organization databases. Patients self-reported as being diagnosed with AS, and as either having received AS treatment or as experiencing AS-related physical activity limitations. An online adapted swing weighting (ASW) method - a pairwise comparison of attributes - was used to elicit attribute trade-offs from 219 patients. Survey data were used to estimate patients' weights for AS treatment attributes, which were incorporated into a quantitative benefit-risk analysis (BRA) to evaluate patients' preferences for TAVR and SAVR. Results: On average, patients put greater value on attributes that favored TAVR than SAVR. Patients' valuation of the lower mortality rate, reduced procedural invasiveness, and quicker time to return to normal quality of life associated with TAVR, offset their valuation of the time over which SAVR has been proven to work. There was substantial heterogeneity in patients' preferences. This was partly explained by age, with differences in preference observed between patients <60 years to those ≥60 years. A Monte Carlo Simulation found that 79.5% of patients prefer TAVR. Conclusions: Most AS patients are willing to tolerate sizable increases in clinical risk in exchange for the benefits of TAVR, resulting in a large proportion of patients preferring TAVR to SAVR. Further work should be undertaken to characterize the heterogeneity in preferences for AS treatment attributes. Shared decision-making tools based on attributes important to patients can support patients' selection of the procedure that best meets their needs.
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Affiliation(s)
- Kevin Marsh
- Patient-Centered Research, Evidera Inc, London, UK
| | | | - Ella Brookes
- Patient-Centered Research, Evidera Inc, London, UK
| | - Carrie Kuehn
- Patient Engagement, Edwards Lifesciences, Washington D.C., USA
| | - Barry Liden
- Patient Engagement, Edwards Lifesciences, Washington D.C., USA
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Marsh K, Hawken N, Brookes E, Kuehn C, Liden B. Patient-centered benefit-risk analysis of transcatheter aortic valve replacement. F1000Res 2019; 8:394. [PMID: 31249679 PMCID: PMC6544076 DOI: 10.12688/f1000research.18796.5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/01/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Aortic stenosis (AS) treatments include surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR). Choosing between SAVR and TAVR requires patients to trade-off benefits and risks. The objective of this research was to determine which TAVR and SAVR outcomes patients consider important, collect quantitative data about how patients weigh benefits and risks, and evaluate patients’ preferences for SAVR or TAVR. Methods: Patients were recruited from advocacy organization databases. Patients self-reported as being diagnosed with AS, and as either having received AS treatment or as experiencing AS-related physical activity limitations. An online adapted swing weighting (ASW) method – a pairwise comparison of attributes – was used to elicit attribute trade-offs from 219 patients. Survey data were used to estimate patients’ weights for AS treatment attributes, which were incorporated into a quantitative benefit-risk analysis (BRA) to evaluate patients’ preferences for TAVR and SAVR. Results: On average, patients put greater value on attributes that favored TAVR than SAVR. Patients’ valuation of the lower mortality rate, reduced procedural invasiveness, and quicker time to return to normal quality of life associated with TAVR, offset their valuation of the time over which SAVR has been proven to work. There was substantial heterogeneity in patients’ preferences. This was partly explained by age, with differences in preference observed between patients <60 years to those ≥60 years. A Monte Carlo Simulation found that 79.5% of patients prefer TAVR. Conclusions: Most AS patients are willing to tolerate sizable increases in clinical risk in exchange for the benefits of TAVR, resulting in a large proportion of patients preferring TAVR to SAVR. Further work should be undertaken to characterize the heterogeneity in preferences for AS treatment attributes. Shared decision-making tools based on attributes important to patients can support patients’ selection of the procedure that best meets their needs.
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Affiliation(s)
- Kevin Marsh
- Patient-Centered Research, Evidera Inc, London, UK
| | | | - Ella Brookes
- Patient-Centered Research, Evidera Inc, London, UK
| | - Carrie Kuehn
- Patient Engagement, Edwards Lifesciences, Washington D.C., USA
| | - Barry Liden
- Patient Engagement, Edwards Lifesciences, Washington D.C., USA
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