The Best of Both Worlds: An Example Mixed Methods Approach to Understand Men's Preferences for the Treatment of Lower Urinary Tract Symptoms.

Abstract

Discrete choice experiments (DCEs) are widely used to quantify individuals' preferences for healthcare. Guidelines recommend the design of DCEs should be informed by qualitative research. However, only a few studies go beyond guidelines by fully presenting qualitative and quantitative research jointly together in a mixed methods approach (MMA). Using an example study about men's preferences for medical treatment of lower urinary tract symptoms (LUTS), we demonstrate how qualitative research can complement DCEs to gain a rich understanding of individuals' preferences. We were the first to combine online discussion groups (ODGs) with an online DCE. A thematic analysis of the ODGs and a conceptual map provided insights into men's quality of life (QoL) with LUTS and relevant treatment attitudes. This was used to design the DCE. Men's willingness to pay (WTP) for these attributes was estimated. Findings from ODGs and DCE were compared to understand WTP and preference heterogeneity. Men mostly valued medicine that reduced urgency and night-time frequencies of urination but avoided sexual side effects. We find heterogeneity in the effect of sexual side effects on men's preferences. The ODGs suggest this is because several men may be sexually inactive due to their age, being widowed or having comorbidities. The ODGs also raised concern about men's awareness of LUTS. We argue that the insights gained into men's preferences for treatment and how LUTS affects men's QoL could not have been obtained by either the qualitative research or the DCE alone.