Pharmacists' Preferences for Providing Patient-Centered Services: A Discrete Choice Experiment to Guide Health Policy

2010 ◽  
Vol 44 (10) ◽  
pp. 1554-1564 ◽  
Author(s):  
Kelly A Grindrod ◽  
Carlo A Marra ◽  
Lindsey Colley ◽  
Ross T Tsuyuki ◽  
Larry D Lynd
Keyword(s):  
Health Policy ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Patient Centered

scholarly journals How Do Patients Want Us to Use the Computer During Medical Encounters?—A Discrete Choice Experiment Study

2021 ◽  
Author(s):  
Cédric Lanier ◽  
Melissa Dominicé Dao ◽  
Dave Baer ◽  
Dagmar M. Haller ◽  
Johanna Sommer ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Primary Care Physicians ◽  
Skills Training ◽  
Experiment Study ◽  
Visual Contact ◽  
Patient Centered ◽  
Clinical Communication ◽  
French Speaking

Abstract Background Primary care physicians (PCPs) now widely use electronic health records (EHRs) during medical encounters. Experts in clinical communication issued recommendations for a patient-centered use of EHRs. However, they have never been validated by patients themselves. Objective To explore patients’ preferences regarding physicians’ EHR-related behaviors. Design Discrete choice experiment study. Patients French-speaking patients waiting for a medical consultation at two outpatient clinics in Geneva, Switzerland. Main Measures We invited patients to watch videos displaying 2 or 3 variations of four specific EHR-related behaviors and asked them to indicate which one they preferred. EHR-related behaviors were (1) typing: continuous/intermittent/handwriting in biomedical or psychosocial focused consultations; (2) maintaining contact while typing: visual/verbal/both; (3) signposting the use of EHR: with/without; (4) position of physicians’ hands and bust: on the keyboard and towards the patient/away from the keyboard and towards the patient/on the keyboard and towards the screen. Key Results Three hundred thirty-six patients participated (response rate 61.4%). They preferred intermittent typing versus handwriting or continuous typing for biomedical issues (32.7%; 95% CI: 26.0–40.2% vs 31.6%; 95% CI: 24.9–39.0% or 14.9%; 95% CI: 10.2–21.1%) and psychosocial issues (38.7%; 95% CI: 31.6–46.3% vs 24.4% 95% CI: 18.4–31.5% or 17.9%; 95% CI; 12.7–24.4%). They favored visual and verbal contact (38.9%; 95% CI: 31.9–46.3%) over verbal (30.3%; 95% CI: 23.9–37.5%) or visual contact only (11.4%; 95% CI: 7.5–17.1%) while the doctor was typing. A majority preferred signposting the use of EHR versus no signposting (58.9%; 95% CI: 53.5–64.0% vs 34.8%; 95% CI: 29.9–40.1%). Finally, half of the patients (49.7%; 95% CI: 42.0–57.4%) favored the position with the physician’s bust towards the patient and hands away from the keyboard. Conclusions Our study shows that patients’ preferences regarding EHR-related behaviors are in line with most experts’ recommendations. Such recommendations should be more consistently integrated into under- and postgraduate communication skills training.

scholarly journals An international discrete choice experiment assessing patients' preferences for disease-modifying therapy attributes in multiple sclerosis

2020 ◽  
Vol 10 (6) ◽  
pp. 369-382
Author(s):  
Birgit Bauer ◽  
Bernd Brockmeier ◽  
Virginia Devonshire ◽  
Arthur Charbonne ◽  
Daniela Wach ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Online Survey ◽  
Treatment Preferences ◽  
Dosing Regimen ◽  
Patient Centered ◽  
Disease Modifying Therapy ◽  
Centered Care

Aim: This discrete choice experiment aimed to assess patients' preferences for treatment attributes in multiple sclerosis (MS). Patients & methods: Patients with relapsing-remitting MS completed an online survey assessing treatment preferences. Descriptive statistical analysis and discrete choice hierarchical Bayesian modeling were performed. Results: Across the overall sample (n = 485), dosing regimen, efficacy and safety were equally important. Within the whole sample, and among those diagnosed <10 years ago, intravenous infusion ≤3 times/year was the preferred dosing regimen; among patients diagnosed ≥10 years ago it was preferred equally to oral treatments. Patients were more willing to accept frequent but mild over rare but severe side effects. Conclusion: Several factors influence patient preferences for MS treatments and must be considered in patient-centered care.

A discrete choice experiment to examine preferences and willingness to pay for prophylactic granulocyte colony-stimulating factors (G-CSF) in previously treated breast cancer patients.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e17509-e17509 ◽  
Author(s):  
Phaedra Johnson ◽  
Tim Bancroft ◽  
Richard L. Barron ◽  
Jason C. Legg ◽  
Xiaoyan Li ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Willingness To Pay ◽  
Cancer Patients ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Choice Experiment ◽  
Risk Of Infection ◽  
Breast Cancer Patients ◽  
Patient Centered

e17509 Background: As patient-centered care becomes more prominent, a better understanding of patient preferences and tradeoffs amongst treatment alternatives and outcomes is needed. This study used a discrete choice experiment to examine the preferences and willingness to pay for prophylactic G-CSF to decrease the incidence of chemotherapy (CT)-induced febrile neutropenia in breast cancer patients who previously received CT. Methods: An online survey was developed with 16 paired treatment choice scenarios comparing 3 alternative G-CSF options (11 versus 1 or 6 versus 1 injections per CT cycle) with a follow-up “no treatment” option. Each scenario had 4 attributes: risk of disruption to CT schedule due to neutropenia, risk of infection requiring hospitalization, frequency of G-CSF administration, and total out-of-pocket (OOP) cost for G-CSF during a CT cycle. Patients’ preferences and willingness to pay (as OOP cost) were estimated using logistic regression. Results: Patients’ (n = 296) preferred G-CSF options with the lowest OOP costs, the fewest injections, and improved outcomes (lowest risk of disruption to CT schedule and lowest risk of infection requiring hospitalization). In the context of this discrete choice experiment, OOP costs and risk of disruption to CT schedule were the most important attributes to patients; risk of infection requiring hospitalization and frequency of G-CSF administration affected patients’ choice of G-CSF option to a smaller but similar degree. Patients were willing to pay OOP $1,076 per cycle to reduce the risk of disrupting the CT schedule from high to low, $884 per cycle to reduce the risk of developing an infection requiring hospitalization from 24% (high) to 7% (low), and $851 and $667 per cycle to decrease the number of G-CSF injections per cycle from 11 to 1 and 6 to 1, respectively. Conclusions: With a current focus on patient-centered approaches in decision-making, physicians need to consider patient preferences when making decisions about therapy, including supportive care agents.

Hospital service quality – patient preferences – a discrete choice experiment

2018 ◽  
Vol 31 (7) ◽  
pp. 676-683 ◽  
Author(s):  
Mina Bahrampour ◽  
Abbas Bahrampour ◽  
Mohammadreza Amiresmaili ◽  
Mohsen Barouni
Keyword(s):  
Health Policy ◽  
Patient Satisfaction ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Choice Experiment ◽  
Healthcare Quality ◽  
High Quality ◽  
Policy Makers ◽  
Content Type

PurposeHigh quality healthcare is important to all patients. If healthcare is felt to be high quality, then patients will be satisfied, and the relationship between patients and healthcare providers will improve. Patient satisfaction is among the most commonly used service quality indicators; however, it is not fully known which factors influence satisfaction. Therefore, it is necessary to pay attention to the elements that affect both healthcare quality and patient satisfaction. Nowadays, several methods are used in health economics to assess patient preferences, prioritize them and help health policy makers improve services. Discrete choice experiment (DCE) is one method that is useful to elicit patient preferences regarding healthcare services. The purpose of this paper is to apply DCE and elicit patient preferences in medical centers to rank certain healthcare quality factors.Design/methodology/approachThe descriptive, analytical study used a cross-sectional questionnaire that the authors developed. In total, 12 scenarios were chosen after applying fractional factorials. The questionnaire was completed by patients who were admitted to Kerman General Teaching Hospitals, South-East Iran in 2015. Patient preferences were identified by calculating the characteristics’ marginal effects and prioritizing them. The generalized estimation equation (GEE) model was used to determine attribute effects on patient preferences.FindingsIn total, 167 patients completed the questionnaire. Prioritizing the attributes showed that “physical examination” was the most important attribute. Other key features included “cleanliness,” “training after discharging,” “medical staff attention,” “waiting for admission” and “staff attitude.” All attributes were statistically significant (p<0.05) except staff behavior. No demographic characteristic was significant.Practical implicationsTo increase hospital patient satisfaction, health policy makers should develop programs to enhance healthcare quality and hospital safety by increasing physical examination quality and other services.Originality/valueTo estimate DCE independent variables, logistic regression models are usually used. The authors used the GEE model to estimate discrete choice experiment owing the explanatory variables’ dependency.

OP31 HTA And Patients’ Preferences: Starting A Discrete Choice Experiment

2019 ◽  
Vol 35 (S1) ◽  
pp. 7-8
Author(s):  
Thomas Poder ◽  
Marion Beffarat ◽  
Maria Benkhalti ◽  
Pierre Dagenais ◽  
Ginette Ladouceur
Keyword(s):  
Decision Making ◽  
Focus Group ◽  
Literature Review ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Selection Process ◽  
Patient Centered ◽  
Care Approach ◽  
Centered Care

IntroductionHospital-based health technology assessment (HB-HTA) needs to consider all relevant data to help decision-making, including patients’ preferences. In this study, we comprehensively describe the process of identification, refinement and selection of attributes and levels for a discrete choice experiment (DCE).MethodsA mixed-methods design was used to identify attributes and levels explaining low back pain (LBP) patients’ choice for a non-surgical treatment. This design combined a systematic literature review with a patients’ focus group, one-on-one interactions with experts and patients, and discussions with stakeholder committee members. Following the patient's focus group, ranking exercises were conducted. A consensus about the attributes and levels was researched during discussions with committee members.ResultsThe literature review yielded 40 attributes to consider in patients’ treatment choice. During the focus group, one additional attribute emerged. The ranking exercises allowed selecting eight attributes for the DCE. These eight attributes and their levels were discussed and validated by the committee members who helped reframe two levels in one of the attributes and delete one attribute. The final seven attributes were: treatment modality, pain reduction, onset of treatment efficacy, duration of efficacy, difficulty in daily living activities, sleep problem, and knowledge about their body and pain.ConclusionsThis study is one of the few to comprehensively describe the selection process of attributes and levels for a DCE. This may help ensure transparency and judge the quality of the decision-making process. In the context of a HB-HTA unit, this strengthens the legitimacy to perform a DCE to better inform decision-makers in a patient-centered care approach.

scholarly journals Moving Toward Patient-Centered Care in Africa: A Discrete Choice Experiment of Preferences for Delivery Care among 3,003 Tanzanian Women

PLoS ONE ◽  
2015 ◽  
Vol 10 (8) ◽  
pp. e0135621 ◽  
Author(s):  
Elysia Larson ◽  
Daniel Vail ◽  
Godfrey M. Mbaruku ◽  
Angela Kimweri ◽  
Lynn P. Freedman ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Patient Centered Care ◽  
Delivery Care ◽  
Patient Centered ◽  
Centered Care
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