Identifying patient preferences for diabetes care: A protocol for implementing a discrete choice experiment in Samoa.
Identifying patient preferences for diabetes care: A protocol for implementing a discrete choice experiment in Samoa.
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DOI：
10.1371/journal.pone.0295845
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发表时间：
2023
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
--
作者：
在萨摩亚，成人2型糖尿病患病率在过去30年中有所增加。患者对护理的偏好是已知影响治疗依从性的因素，并与疾病进展和严重程度降低相关。然而，患者对糖尿病护理的偏好，一般来说，研究不足，其他以患者为中心的因素，如支付意愿（WTP）的糖尿病治疗从来没有在这种情况下进行过探索。离散选择实验（DCE）是一个有用的工具，以获得偏好和卫生保健的支付意愿。DCE为患者提供了由一系列由属性和水平组成的多选项选择配置文件组成的假设场景。患者选择的基础上，属性和水平可能是更可取的，从而量化和识别本地相关的以患者为中心的偏好配置文件。本文介绍了协议的设计，试点和实施的DCE确定患者的偏好糖尿病护理，在萨摩亚。采用探索性序贯混合方法设计，使用文献综述和半结构化访谈的形成性数据（n = 20名萨摩亚成人2型糖尿病患者）设计最佳DCE工具。实验设计程序被用来减少选择集的数量和平衡的仪器。在试点测试之后，将对n = 450名萨摩亚糖尿病成年人进行DCE，沿着相关问卷调查和人体测量。随后，我们还将纵向评估护理偏好如何随时间变化。将使用渐进式混合秩序Logit模型分析数据。结果将确定哪些糖尿病护理属性对患者重要（p < 0.05），检查参与者特征和偏好之间的关联，阐明参与者愿意做出的权衡，以及接受的概率，以及特定属性和水平的WTP。本研究的结果将为设计和调整有效的糖尿病干预和治疗方法提供完整的数据。
In Samoa, adult Type 2 diabetes prevalence has increased within the past 30 years. Patient preferences for care are factors known to influence treatment adherence and are associated with reduced disease progression and severity. However, patient preferences for diabetes care, generally, are understudied, and other patient-centered factors such as willingness-to-pay (WTP) for diabetes treatment have never been explored in this setting. Discrete Choice Experiments (DCE) are useful tools to elicit preferences and WTP for healthcare. DCEs present patients with hypothetical scenarios composed of a series of multi-alternative choice profiles made up of attributes and levels. Patients choose a profile based on which attributes and levels may be preferable for them, thereby quantifying and identifying locally relevant patient-centered preferences. This paper presents the protocol for the design, piloting, and implementation of a DCE identifying patient preferences for diabetes care, in Samoa. Using an exploratory sequential mixed methods design, formative data from a literature review and semi-structured interviews with n = 20 Samoan adults living with Type 2 diabetes was used to design a Best-Best DCE instrument. Experimental design procedures were used to reduce the number of choice-sets and balance the instrument. Following pilot testing, the DCE is being administered to n = 450 Samoan adults living with diabetes, along with associated questionnaires, and anthropometrics. Subsequently, we will also be assessing longitudinally how preferences for care change over time. Data will be analyzed using progressive mixed Rank Order Logit models. The results will identify which diabetes care attributes are important to patients (p < 0.05), examine associations between participant characteristics and preference, illuminate the trade-offs participants are willing to make, and the probability of uptake, and WTP for specific attributes and levels. The results from this study will provide integral data useful for designing and adapting efficacious diabetes intervention and treatment approaches in this setting.
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