scholarly journals Investigating Patients’ Preferences to Inform Drug Development Decisions: Novel Insights From a Discrete Choice Experiment in Migraine

2020 ◽  
Author(s):  
Aleksandra Torbica ◽  
Carla Rognoni ◽  
Rosanna Tarricone
Keyword(s):  
Adverse Events ◽  
Research And Development ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Treatment Effect ◽  
Choice Experiment ◽  
Preference Heterogeneity ◽  
Current Evidence ◽  
Symptom Intensity ◽  
The Impact

Abstract Background: Chronic conditions have important long-term consequences for patients’ personal and social lives and require patient commitment to their management. In this context, the assessment of patients’ preferences for treatment characteristics would increase the current evidence on the impact of diseases to support decision-making processes in the field of public policies and research and development in pharmaceutical industries.The present study used cases of chronic migraine to assess patients’ preferences, including the analysis of gender differences, for the characteristics of an ideal migraine treatment. Methods: A discrete choice experiment was performed with 466 adults with migraine in Italy who experienced at least 4 attacks per month. We investigated the preferences of patients with respect to five treatment attributes that were identified from a systematic literature review and two focus group elicitations. The heterogeneity of preferences was investigated in a mixed logit model with normally distributed random coefficients.Results: Overall, the respondents considered the presence of adverse events, duration of the treatment effect, reduction of symptom intensity, speed of the effect and the 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.Conclusions: 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.

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.

scholarly journals Patient preferences for use of virtual consultations in an orthopaedic rehabilitation setting: Results from a discrete choice experiment

2021 ◽  
pp. 135581962110354
Author(s):  
Anthony W Gilbert ◽  
Emmanouil Mentzakis ◽  
Carl R May ◽  
Maria Stokes ◽  
Jeremy Jones
Keyword(s):  
Conceptual Model ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Choice Experiment ◽  
Best Practice ◽  
Time Of Day ◽  
Problem Area ◽  
Fractional Factorial ◽  
The Impact

Objective Virtual Consultations may reduce the need for face-to-face outpatient appointments, thereby potentially reducing the cost and time involved in delivering health care. This study reports a discrete choice experiment (DCE) that identifies factors that influence patient preferences for virtual consultations in an orthopaedic rehabilitation setting. Methods Previous research from the CONNECT (Care in Orthopaedics, burdeN of treatmeNt and the Effect of Communication Technology) Project and best practice guidance informed the development of our DCE. An efficient fractional factorial design with 16 choice scenarios was created that identified all main effects and partial two-way interactions. The design was divided into two blocks of eight scenarios each, to reduce the impact of cognitive fatigue. Data analysis were conducted using binary logit regression models. Results Sixty-one paired response sets (122 subjects) were available for analysis. DCE factors (whether the therapist is known to the patient, duration of appointment, time of day) and demographic factors (patient qualifications, access to equipment, difficulty with activities, multiple health issues, travel costs) were significant predictors of preference. We estimate that a patient is less than 1% likely to prefer a virtual consultation if the patient has a degree, is without access to the equipment and software to undertake a virtual consultation, does not have difficulties with day-to-day activities, is undergoing rehabilitation for one problem area, has to pay less than £5 to travel, is having a consultation with a therapist not known to them, in 1 weeks’ time, lasting 60 minutes, at 2 pm. We have developed a simple conceptual model to explain how these factors interact to inform preference, including patients’ access to resources, context for the consultation and the requirements of the consultation. Conclusions This conceptual model provides the framework to focus attention towards factors that might influence patient preference for virtual consultations. Our model can inform the development of future technologies, trials, and qualitative work to further explore the mechanisms that influence preference.

scholarly journals Job preferences of undergraduate pharmacy students in China: a discrete choice experiment

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Ping Liu ◽  
Shimeng Liu ◽  
Tiantian Gong ◽  
Quan Li ◽  
Gang Chen ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Rural Areas ◽  
Choice Experiment ◽  
Job Characteristics ◽  
Pharmacy Students ◽  
Preference Heterogeneity ◽  
Short Supply ◽  
Job Preferences ◽  
Open Management

Abstract Background Pharmacists are a crucial part of the health workforce and play an important role in achieving universal health coverage. In China, pharmaceutical human resources are in short supply, and the distribution is unequal. This study aimed to identify the key job characteristics that influence the job preferences of undergraduate pharmacy students and to elicit the relative importance of different job characteristics to shed light on future policy interventions. Methods A discrete choice experiment was conducted to assess the job preferences of undergraduate pharmacy students from 6 provinces in mainland China. A face-to-face interview was used to collect data. Conditional logit and mixed logit models were used to analyse data, and the final model was chosen according to the model fit statistics. A series of policy simulations was also conducted. Results In total, 581 respondents completed the questionnaire, and 500 respondents who passed the internal consistency test were analysed. All attributes were statistically significant except for open management. Monthly income and work location were most important to respondents, followed by work unit (which refers to the nature of the workplace) and years to promotion. There was preference heterogeneity among respondents, e.g., male students preferred open management, and female students preferred jobs in public institutions. Furthermore, students with an urban background or from a single-child family placed higher value on a job in the city compared to their counterparts. Conclusion The heterogeneity of attributes showed the complexity of job preferences. Both monetary and nonmonetary job characteristics significantly influenced the job preferences of pharmacy students in China. A more effective policy intervention to attract graduates to work in rural areas should consider both incentives on the job itself and the background of pharmacy school graduates.

scholarly journals Assessing cigarette packaging and labelling policy effects on early adolescents: results from a discrete choice experiment

2020 ◽  
pp. tobaccocontrol-2019-055463
Author(s):  
Inti Barrientos-Gutierrez ◽  
Farahnaz Islam ◽  
Yoo Jin Cho ◽  
Ramzi George Salloum ◽  
Jordan Louviere ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Early Adolescents ◽  
Interactive Effects ◽  
Brand Name ◽  
Warning Label ◽  
Plain Packaging ◽  
Tobacco Marketing ◽  
The Impact

IntroductionCigarette packaging is a primary channel for tobacco advertising, particularly in countries where traditional channels are restricted. The current study evaluated the independent and interactive effects of cigarette packaging and health warning label (HWL) characteristics on perceived appeal of cigarette brands for early adolescents in Mexico.MethodsA discrete choice experiment (DCE) was conducted with early adolescents, aged 12–14 years (n=4251). The DCE involved a 3×25 design with six attributes: brand (Marlboro, Pall Mall, Camel), tobacco flavour (regular, menthol), flavour capsule (none, 1 or 2 capsules), presence of descriptive terms, branding (vs plain packaging), HWL size (30%, 75%) and HWL content (emphysema vs mouth cancer). Participants viewed eight sets of three cigarette packs and selected a pack in each set that: (1) is most/least attractive, (2) they are most/least interested in trying or (3) is most/least harmful, with a no difference option.ResultsParticipants perceived packs as less attractive, less interesting to try and more harmful if they had plain packaging or had larger HWLs, with the effect being most pronounced when plain packaging is combined with larger HWLs. For attractiveness, plain packaging had the biggest influence on choice (43%), followed by HWL size (19%). Interest in trying was most influenced by brand name (34%), followed by plain packaging (29%). Perceived harm was most influenced by brand name (30%), followed by HWL size (29%).ConclusionIncreasing the size of HWLs and implementing plain packaging appear to reduce the appeal of cigarettes to early adolescents. Countries should adopt these policies to minimise the impact of tobacco marketing.

scholarly journals Duration of Treatment Effect Should Be Considered in the Design and Interpretation of Clinical Trials: Results of a Discrete Choice Experiment

2019 ◽  
Vol 39 (4) ◽  
pp. 461-473 ◽  
Author(s):  
Bethan Copsey ◽  
James Buchanan ◽  
Raymond Fitzpatrick ◽  
Sarah E. Lamb ◽  
Susan J. Dutton ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Disease Severity ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Treatment Effect ◽  
Heart Attack ◽  
Choice Experiment ◽  
Ulcer Bleeding ◽  
Duration Of Treatment ◽  
Duration Of Effect

Objective. This study examined whether duration of treatment effect should be considered in a benefit-risk assessment using a case study of osteoarthritis medications. Study Design and Setting. A discrete choice experiment was completed by 300 residents of the United Kingdom with hip and/or knee osteoarthritis. In 16 choice tasks, participants selected their preferred option from 2 medications. Medications were described in terms of effect on pain, stiffness, and function; duration of treatment effect; and risk of heart attack and stomach ulcer bleeding. The analysis used mixed-effects logistic regression. Results. Pain, disease severity, and duration of treatment effect had the greatest influence on medication preferences, whereas stiffness did not significantly affect medication choice. Participants were willing to accept an increase in the risk of heart attack of 2.6% (95% confidence interval: 2.0% to 3.2%) to increase the duration of treatment effect from 1 month to 12 months. Reducing pain from moderate to mild was valued the same as increasing duration of effect from 1 month to 3 months; both were seen as equivalent to an absolute reduction of 1.2% in the risk of heart attack in the next year. Subgroup analysis suggested disease severity influenced patient preferences. Conclusions. Along with treatment benefits and risks, the results suggest that duration of treatment effect is an important factor in the medication choices of people with osteoarthritis. This could have implications for the design and interpretation of clinical trials, for example, incorporating longer-term surveillance of trial participants and accounting for duration of treatment effect in risk-benefit assessments. Future research is needed to assess whether these findings are generalizable to other samples, disease areas, and levels of duration of effect.

scholarly journals A protocol for a discrete choice experiment: understanding preferences of patients with cancer towards their cancer care across metropolitan and rural regions in Australia

BMJ Open ◽  
2014 ◽  
Vol 4 (10) ◽  
pp. e006661 ◽  
Author(s):  
Shu Fen Wong ◽  
Richard Norman ◽  
Trisha L Dunning ◽  
David M Ashley ◽  
Paula K Lorgelly
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Cancer Care ◽  
Choice Experiment ◽  
Fractional Factorial ◽  
Medical Decision ◽  
Preference Heterogeneity ◽  
Related Factors ◽  
Patients With Cancer ◽  
Clinical Scenarios

IntroductionMedical decision-making in oncology is a complicated process and to date there are few studies examining how patients with cancer make choices with respect to different features of their care. It is also unknown whether patient choices vary by geographical location and how location could account for observed rural and metropolitan cancer differences. This paper describes an ongoing study that aims to (1) examine patient and healthcare-related factors that influence choices of patients with cancer; (2) measure and quantify preferences of patients with cancer towards cancer care using a discrete choice experiment (DCE) and (3) explore preference heterogeneity between metropolitan and rural locations.Methods and analysisA DCE is being conducted to understand how patients with cancer choose between two clinical scenarios accounting for different patient and healthcare-related factors (and levels). Preliminary qualitative research was undertaken to guide the development of an appropriate DCE design including characteristics that are important and relevant to patients with cancer. A fractional factorial design using the D-efficiency criteria was used to estimate interactions among attributes. Multinomial logistic regression will be used for the primary DCE analysis and to control for sociodemographic and clinical characteristics.Ethics and disseminationThe Barwon Health Human Research Ethics Committee approved the study. Findings from the study will be presented in national/international conferences and peer-reviewed journals. Our results will form the basis of a feasibility study to inform the development of a larger scale study into preferences of patients with cancer and their association with cancer outcomes.

scholarly journals Analyzing preferences for family doctor contract services in rural China: a study using discrete choice experiment

2019 ◽  
Author(s):  
peipei Fu ◽  
Yi Wang ◽  
Shimeng Liu ◽  
Jiajia Li ◽  
qiufeng Gao ◽  
...  
Keyword(s):  
Educational Attainment ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Family Doctor ◽  
Preference Heterogeneity ◽  
Reimbursement Rate ◽  
Rural Residents ◽  
The Family ◽  
Good Attitude

Abstract Background: Preliminary evaluations have found that family doctor contract service has significantly controlled medical expenses, better managed chronic diseases, and increased patient satisfaction and service compliance. In 2016, China proposed the establishment of a family doctor system to carry out contract services, but studies have found uptake and utilization of these services to be limited. This study aimed to investigate rural resident preferences for FDCS from the public perspective in China. Methods : A discrete choice experiment (DCE) was performed to elicit respondent preferences towards FDCS among rural residents in China. Attributes and levels were established based on literature review and qualitative methods. Five attributes consisted of cost, medicine availability, reimbursement rate, competence of the family doctor, and attitude of the family doctor were evaluated using mixed logit model. Results: A total number of 609 residents were included in the main DCE analysis. Respondents valued high competence (coefficient 2.44, [SE 0.13]) and good attitude (coefficient 1.42, [SE 0.09]) of the family doctor most. Cost was negatively valued (coefficient -0.01, [SE 0.01]) as expected. The preference heterogeneity analysis was conducted after adjusting the interaction terms, we found that rural residents with lower educational attainment prefer good attitude than those with higher educational attainment counterparts. The estimated willingness to pay (WTP) for “high” relative to “low” competence was 441.13 RMB/year and WTP for a provider with a “good” relative to a “poor” attitude was 255.77 RMB/year. Conclusion: This present study suggested priorities should be given to strengthen and improve the quality of primary health care including family doctors’ competence and attitudes so as to increase the uptake of signing FDCS. The contract service package including annual cost, insurance reimbursement rate and individualized services should be redesigned and become congruent with residents with different health status and their stated preferences.

Preference of Virtual Reality Game in Psychological Pressure and Depression Prevention: A Discrete Choice Experiment (Preprint)

2021 ◽  
Author(s):  
Shan Jin ◽  
Zijian Tan ◽  
Taoran Liu ◽  
Sze Ngai Chan ◽  
Jie Sheng ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Adverse Events ◽  
University Students ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Psychological Intervention ◽  
Monthly Cost ◽  
Depression Prevention ◽  
Psychological Pressure

BACKGROUND Virtual reality (VR) can be used to build many different scenes aimed at reducing study-related stress. However, few academic experiments about university students for preference testing have been done. Our study aimed to assess the preference of VR games for stress and depression prevention by using a discrete choice experiment (DCE). OBJECTIVE The candidate could wear the headset and alleviate the stress and depression in the game. The purpose of this experiment was to investigate the preference of VR technology in college students’ psychological pressure relief and depression prevention. METHODS Five different attributes were selected based on the depression therapy parameter and attributes about VR: (1) treatment modality, (2) therapy duration, (3) perceived remission rate, (4) probability of adverse events, and the (5) monthly cost of adding treatment to a discrete choice experiment. By comparing different attributes and levels, we could draw some conclusions about the depression therapy testing preference for university students. One university student was responsible for VR scene development and one for candidate recruitment. RESULTS The utility report of different attributes for “zero” probability of adverse events was higher than others (99.22), and the VR treatment as the most popular treatment method when compared with counseling and medicine treatment was 80.95. Three parameter aspects (different treatments for depression) were statistically significant (P＜0.001), including “0%” and “50%” of “Probability of adverse events” and “RMB$500” of “The monthly cost of treatment”. Most individuals preferred 12 months as the therapy duration, and the odds ratio of “12 months” was 1.095 (95% confidence interval [CI] 0.945–1.270) when compared with the reference of level of “6 months”. Meanwhile, the cheapest price (RMB $500) of depression therapy was the optimum choice for most students. CONCLUSIONS People placed great preference on VR technology psychological intervention methods, which indicates that VR may have a potential market in prevention and treatment of psychological problems. However, adverse events and treatment costs need to be considered. This study can be used to guide policies that are relevant to the development of application of VR technology in the field of psychological pressure and depression prevention. INTERNATIONAL REGISTERED REPORT RR2-doi:10.2196/29375

Sign in / Sign up

Export Citation Format

Share Document