David M Meads1, John L O'Dwyer2, Claire T Hulme2, Phani Chintakayala3, Karen Vinall-Collier2,4, Michael I Bennett5. 1. Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Leeds, UK. D.Meads@leeds.ac.uk. 2. Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Leeds, UK. 3. Leeds University Business School and Leeds Institute for Data Analytics, University of Leeds, Leeds, UK. 4. School of Dentistry, University of Leeds, Leeds, UK. 5. Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
Abstract
BACKGROUND: Pain from advanced cancer remains prevalent, severe and often under-treated. AIM: The aim of this study was to conduct a discrete choice experiment with patients to understand their preferences for pain management services and inform service development. METHODS: Focus groups were used to develop the attributes and levels of the discrete choice experiment. The attributes were: waiting time, type of healthcare professional, out-of-pocket costs, side-effect control, quality of communication, quality of information and pain control. Patients completed the discrete choice experiment along with clinical and health-related quality of life questions. Conditional and mixed logit models were used to analyse the data. RESULTS: Patients with cancer pain (n = 221) and within palliative care services completed the survey (45% were female, mean age 64.6 years; age range 21-92 years). The most important aspects of pain management were: good pain control, zero out-of-pocket costs and good side-effect control. Poor or moderate pain control and £30 costs drew the highest negative preferences. Respondents preferred control of side effects and provision of better information and communication, over access to certain healthcare professionals. Those with lower health-related quality of life were less willing to wait for treatment and willing to incur higher costs. The presence of a carer influenced preferences. CONCLUSIONS: Outcome attributes were more important than process attributes but the latter were still valued. Thus, supporting self-management, for example by providing better information on pain may be a worthwhile endeavour. However, service provision may need to account for individual characteristics given the heterogeneity in preferences.
BACKGROUND: Pain from advanced cancer remains prevalent, severe and often under-treated. AIM: The aim of this study was to conduct a discrete choice experiment with patients to understand their preferences for pain management services and inform service development. METHODS: Focus groups were used to develop the attributes and levels of the discrete choice experiment. The attributes were: waiting time, type of healthcare professional, out-of-pocket costs, side-effect control, quality of communication, quality of information and pain control. Patients completed the discrete choice experiment along with clinical and health-related quality of life questions. Conditional and mixed logit models were used to analyse the data. RESULTS: Patients with cancer pain (n = 221) and within palliative care services completed the survey (45% were female, mean age 64.6 years; age range 21-92 years). The most important aspects of pain management were: good pain control, zero out-of-pocket costs and good side-effect control. Poor or moderate pain control and £30 costs drew the highest negative preferences. Respondents preferred control of side effects and provision of better information and communication, over access to certain healthcare professionals. Those with lower health-related quality of life were less willing to wait for treatment and willing to incur higher costs. The presence of a carer influenced preferences. CONCLUSIONS: Outcome attributes were more important than process attributes but the latter were still valued. Thus, supporting self-management, for example by providing better information on pain may be a worthwhile endeavour. However, service provision may need to account for individual characteristics given the heterogeneity in preferences.
Entities:
Keywords:
Cancer Pain; Discrete Choice Experiment; Pain Control; Pain Management; Palliative Care Service
Authors: Axel C Mühlbacher; Uwe Junker; Christin Juhnke; Edgar Stemmler; Thomas Kohlmann; Friedhelm Leverkus; Matthias Nübling Journal: Eur J Health Econ Date: 2014-06-21
Authors: B Gomes; I J Higginson; N Calanzani; J Cohen; L Deliens; B A Daveson; D Bechinger-English; C Bausewein; P L Ferreira; F Toscani; A Meñaca; M Gysels; L Ceulemans; S T Simon; H R W Pasman; G Albers; S Hall; F E M Murtagh; D F Haugen; J Downing; J Koffman; F Pettenati; S Finetti; B Antunes; R Harding Journal: Ann Oncol Date: 2012-02-16 Impact factor: 32.976
Authors: M H J van den Beuken-van Everdingen; J M de Rijke; A G Kessels; H C Schouten; M van Kleef; J Patijn Journal: Ann Oncol Date: 2007-03-12 Impact factor: 32.976
Authors: Suzana Karim; Benjamin M Craig; Caroline Vass; Catharina G M Groothuis-Oudshoorn Journal: Pharmacoeconomics Date: 2022-08-12 Impact factor: 4.558
Authors: Matthew J Allsop; Alexandra Wright-Hughes; Kath Black; Suzanne Hartley; Marie Fletcher; Lucy E Ziegler; Bridgette M Bewick; David Meads; Nicholas D Hughes; S José Closs; Claire Hulme; Sally Taylor; Kate Flemming; Julia Hackett; John L O'Dwyer; Julia M Brown; Michael I Bennett Journal: BMJ Open Date: 2018-03-22 Impact factor: 2.692
Authors: Hiba El Masri; Treasure M McGuire; Mieke L van Driel; Helen Benham; Samantha A Hollingworth Journal: Patient Prefer Adherence Date: 2022-09-20 Impact factor: 2.314
Authors: Katy E Trinkley; Michael G Kahn; Larry A Allen; Heather Haugen; Miranda E Kroehl; Chen-Tan Lin; Daniel C Malone; Daniel D Matlock Journal: Patient Prefer Adherence Date: 2020-11-10 Impact factor: 2.711