scholarly journals Provider preferences for delivery of HIV care coordination services: results from a discrete choice experiment

2021 ◽  
Author(s):  
Rebecca Zimba ◽  
Chunki Fong ◽  
Madellena Conte ◽  
Abigail Baim-Lance ◽  
McKaylee Robertson ◽  
...  
Keyword(s):  
Primary Care ◽  
New York ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Care Coordination ◽  
Choice Experiment ◽  
Hiv Care ◽  
Relative Importance ◽  
Directly Observed Therapy ◽  
Four Levels

Introduction The PROMISE study was launched in 2018 to assess and document the implementation of changes to an existing HIV Care Coordination Program (CCP) designed to address persistent disparities in care and treatment engagement among persons with HIV in New York City. We evaluated provider endorsement of features of the CCP to identify opportunities for improvement. Methods We used a discrete choice experiment (DCE) to measure provider endorsement of four CCP attributes, including: a) how CCP helps with medication adherence, b) how CCP helps with primary care appointments, c) how CCP helps with issues other than primary care, and d) where CCP visits take place (visit location). Each attribute had three to four levels. Our primary outcomes were relative importance and part-worth utilities, measures of preference for the levels of the four CCP program attributes. Results Visit location (28.6%) had the highest relative importance, followed by how staff help with ART adherence (24.3%), how staff help with issues other than primary care (24.2%), and how staff help with primary care appointments (22.9%). Within each of the above attributes, respectively, the levels with the highest part-worth utilities were home visits 60 minutes from the program or agency (19.9 utiles, 95% CI 10.7-29.0), directly observed therapy (26.1 utiles, 95% CI 19.1-33.1), help with non-HIV specialty medical care (26.5 utiles, 95% CI 21.5-31.6), and reminding clients about and accompanying them to primary care appointments (20.8 utiles, 95% CI 15.6-26.0). Conclusions Ongoing CCP refinements should account for how best to support and evaluate the intensive CCP components endorsed by providers in this study.

scholarly journals Discrete choice experiment for eliciting preference for health services for patients with ALS and their informal caregivers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Katy Tobin ◽  
Sinead Maguire ◽  
Bernie Corr ◽  
Charles Normand ◽  
Orla Hardiman ◽  
...  
Keyword(s):  
Health Services ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Strong Preference ◽  
Multidisciplinary Teams ◽  
Relative Importance ◽  
Trade Offs ◽  
Als Patients ◽  
The Impact

Abstract Background Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative condition with a mean life expectancy of 3 years from first symptom. Understanding the factors that are important to both patients and their caregivers has the potential to enhance service delivery and engagement, and improve efficiency. The Discrete Choice Experiment (DCE) is a stated preferences method which asks service users to make trade-offs for various attributes of health services. This method is used to quantify preferences and shows the relative importance of the attributes in the experiment, to the service user. Methods A DCE with nine choice sets was developed to measure the preferences for health services of ALS patients and their caregivers and the relative importance of various aspects of care, such as timing of care, availability of services, and decision making. The DCE was presented to patients with ALS, and their caregivers, recruited from a national multidisciplinary clinic. A random effects probit model was applied to estimate the impact of each attribute on a participant’s choice. Results Patients demonstrated the strongest preferences about timing of receiving information about ALS. A strong preference was also placed on seeing the hospice care team later rather than early on in the illness. Patients also indicated their willingness to consider the use of communication devices. Grouping by stage of disease, patients who were in earlier stages of disease showed a strong preference for receipt of extensive information about ALS at the time of diagnosis. Caregivers showed a strong preference for engagement with healthcare professionals, an attribute that was not prioritised by patients. Conclusions The DCE method can be useful in uncovering priorities of patients and caregivers with ALS. Patients and caregivers have different priorities relating to health services and the provision of care in ALS, and patient preferences differ based on the stage and duration of their illness. Multidisciplinary teams must calibrate the delivery of care in the context of the differing expectations, needs and priorities of the patient/caregiver dyad.

Parent and Primary Care Provider Priorities for Wellness in Early Childhood: A Discrete Choice Experiment

2021 ◽  
Author(s):  
Stephanie L. Mayne ◽  
Chloe Hannan ◽  
Jennifer Faerber ◽  
Rupreet Anand ◽  
Ella Labrusciano-Carris ◽  
...  
Keyword(s):  
Primary Care ◽  
Early Childhood ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Care Provider ◽  
Primary Care Provider ◽  
Choice Experiment

scholarly journals Public preferences for primary care provision in Germany – a discrete choice experiment

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Kim-Sarah Krinke ◽  
Ulla Tangermann ◽  
Volker Eric Amelung ◽  
Christian Krauth
Keyword(s):  
Primary Care ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Care Provision ◽  
Public Preferences

scholarly journals Preferences for transitional HIV care among people living with HIV recently released from prison in Zambia: a discrete choice experiment

2021 ◽  
Vol 24 (10) ◽  
Author(s):  
Jan Ostermann ◽  
Valerie Yelverton ◽  
Helene J. Smith ◽  
Mirriam Nanyangwe ◽  
Lillian Kashela ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Living With Hiv

scholarly journals Patients’ preferences for GP consultation for perceived cancer risk in primary care: a discrete choice experiment

2017 ◽  
Vol 67 (659) ◽  
pp. e388-e395 ◽  
Author(s):  
Katriina L Whitaker ◽  
Alex Ghanouni ◽  
Yin Zhou ◽  
Georgios Lyratzopoulos ◽  
Stephen Morris
Keyword(s):  
Primary Care ◽  
Cancer Risk ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Online Survey ◽  
Population Characteristics ◽  
Risk Level ◽  
Listening Skills ◽  
Potential Cancer

BackgroundContacting a doctor for advice when experiencing a potential cancer symptom is an important step in early diagnosis, but barriers to consultation are commonly reported. Understanding barriers to consulting in primary care within the cancer context provides opportunities to improve earlier diagnosis of cancerAimTo investigate patients’ GP consultation preferences when presented with a potential cancer symptom, and to describe whether these preferences are mediated by variable levels of cancer risk.Design and settingA UK-wide online survey of adults ≥50 years old, using quota sampling to reflect general population characteristics.MethodA discrete choice experiment examined participants’ preferences for primary care consultation for three cancer symptom scenarios: risk level not mentioned, risk designated as ‘low’, or risk designated as ‘high’. Scenarios based on length of consultation, time to getting an appointment, convenience, choice of GP, and GP listening skills were presented in a self-completed online questionnaire.ResultsA total of 9616 observations were obtained from 601 participants. Participants expressed preferences for doctors with better listening skills, the ability to see a GP of their choice, and shorter waiting times. These findings were the same across risk conditions and demographic groups. Participants were willing to wait an extra 3.5 weeks for an appointment with a doctor with good/very good listening skills (versus very poor listening skills) and an extra week for an appointment with a GP of their choice (versus any GP).ConclusionPatient decisions about help seeking seem to be particularly influenced by the anticipated listening skills of doctors. Improving doctors’ communication skills may in the longer term encourage people to seek prompt medical help when they experience a cancer symptom.

scholarly journals SARS-CoV-2 Testing Service Preferences of Adults in the United States: Discrete Choice Experiment (Preprint)

2020 ◽  
Author(s):  
Rebecca Zimba ◽  
Sarah Kulkarni ◽  
Amanda Berry ◽  
William You ◽  
Chloe Mirzayi ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Turnaround Time ◽  
Urgent Care ◽  
Relative Importance ◽  
Test Type ◽  
Specimen Type ◽  
Testing Uptake ◽  
Community Transmission

BACKGROUND Ascertaining preferences for SARS-CoV-2 testing and incorporating findings into the design and implementation of strategies for delivering testing services may enhance testing uptake and engagement, a prerequisite to reducing onward transmission. OBJECTIVE This study aims to determine important drivers of decisions to obtain a SARS-CoV-2 test in the context of increasing community transmission. METHODS We used a discrete choice experiment to assess preferences for SARS-CoV-2 test type, specimen type, testing venue, and results turnaround time. Participants (n=4793) from the US national longitudinal Communities, Households and SARS-CoV-2 Epidemiology (CHASING) COVID Cohort Study completed our online survey from July 30 to September 8, 2020. We estimated the relative importance of testing method attributes and part-worth utilities of attribute levels, and simulated the uptake of an optimized testing scenario relative to the current typical testing scenario of polymerase chain reaction (PCR) via nasopharyngeal swab in a provider’s office or urgent care clinic with results in >5 days. RESULTS Test result turnaround time had the highest relative importance (30.4%), followed by test type (28.3%), specimen type (26.2%), and venue (15.0%). In simulations, immediate or same-day test results, both PCR and serology, or oral specimens substantially increased testing uptake over the current typical testing option. Simulated uptake of a hypothetical testing scenario of PCR and serology via a saliva sample at a pharmacy with same-day results was 97.7%, compared to 0.6% for the current typical testing scenario, with 1.8% opting for no test. CONCLUSIONS Testing strategies that offer both PCR and serology with noninvasive methods and rapid turnaround time would likely have the most uptake and engagement among residents in communities with increasing community transmission of SARS-CoV-2.

What matters most to patients when choosing treatment for mild–moderate asthma? Results from a discrete choice experiment

Thorax ◽  
2020 ◽  
Vol 75 (10) ◽  
pp. 842-848
Author(s):  
Christina Baggott ◽  
Paul Hansen ◽  
Robert J Hancox ◽  
Jo Katherine Hardy ◽  
Jenny Sparks ◽  
...  
Keyword(s):  
Treatment Regimen ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Controlled Trial ◽  
Final Analysis ◽  
Mild Asthma ◽  
Relative Importance ◽  
Shortness Of Breath ◽  
Moderate Asthma

BackgroundAn as-needed combination preventer and reliever regimen was recently introduced as an alternative to conventional daily preventer treatment for mild asthma. In a subgroup analysis of the PRACTICAL study, a pragmatic randomised controlled trial of budesonide–formoterol reliever therapy versus maintenance budesonide plus terbutaline reliever therapy in adults with mild asthma, we recently reported that about two-thirds preferred as-needed combination preventer and reliever therapy. The aim of this study was to determine the relative importance of attributes associated with these two asthma therapies in this subgroup of participants who indicated their preferred treatment in the PRACTICAL study.MethodsAt their final study visit, a subgroup of participants indicated their preferred treatment and completed a discrete choice experiment using the Potentially All Pairwise RanKings of all possible Alternatives method and 1000minds software. Treatment attributes and their levels were selected from measurable study outcomes, and included: treatment regimen, shortness of breath, steroid dose and likelihood of asthma flare-up.ResultsThe final analysis dataset included 288 participants, 64% of whom preferred as-needed combination preventer and reliever. Of the attributes, no shortness of breath and lowest risk of asthma flare-up were ranked highest and second highest, respectively. However, the relative importance of the other two attributes varied by preferred therapy: treatment regimen was ranked higher by participants who preferred as-needed treatment than by participants who preferred maintenance treatment.ConclusionsKnowledge of patient preferences for treatment attributes together with regimen characteristics can be used in shared decision-making regarding choice of treatment for patients with mild–moderate asthma.Trial registration numberACTRN12616000377437.

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