Abstract
BackgroundParticipation rates of lifestyle programs among type 2 diabetes mellitus (T2DM) patients are less than optimal around the globe. Whereas research shows notable delays in the development of the disease among lifestyle program participants. Very little is known about the relative importance of barriers for participation as well as the willingness of T2DM patients to pay for participation in such programs. The aim of this study was to identify the preferences of T2DM patients with regard to lifestyle programs and to calculate participants’ willingness to pay (WTP) as well as to estimate the potential participation rates of lifestyle programs.MethodsA Discrete Choice Experiment (DCE) questionnaire assessing five different lifestyle program attributes was distributed among 1250 Dutch adults aged 35–65 years with T2DM, 391 questionnaires (31%) were returned and included in the analysis. The relative importance of the program attributes (i.e., meal plan, physical activity (PA) schedule, consultation structure, expected program outcome and out-of-pocket costs) was determined using panel-mixed logit models. Based on the retrieved attribute estimates, patients’ WTP and potential participation rates were determined.ResultsThe out-of-pocket costs (β = −0.75, P < .001), consultation structure (β = −0.46, P < .001) and expected outcome (β = 0.72, P < .001) were the most important factors for respondents when deciding whether to participate in a lifestyle program. Respondents were willing to pay €128 per year for individual instead of group consultation and €97 per year for 10 kilograms anticipated weight loss. Potential participation rates for different lifestyle-program scenarios ranged between 48.5% and 62.4%.ConclusionsWhen deciding whether to participate in a lifestyle program, T2DM patients are mostly driven by low levels of out-of-pocket costs. Thereafter, they prefer individual consultation and high levels of anticipated outcomes with respect to weight loss.
Highlights
Participation rates of lifestyle programs among type 2 diabetes mellitus (T2DM) patients are less than optimal around the globe
Patient preferences Most of the attribute estimates were significant, indicating that they were important for T2DM patients when choosing whether to participate in a lifestyle program (Table 4)
The greater the expected outcome in terms of weight loss, the more willing participants were to participate and higher out-of-pocket costs led to a decrease in their willingness to participate
Summary
Participation rates of lifestyle programs among type 2 diabetes mellitus (T2DM) patients are less than optimal around the globe. There appears to be notable delays in the development of the disease and the onset of diabetes-related complications among participants in among patients within this specific age group are expected to have a greater and more long-term impact on disease progress than among older T2DM patients [12]. These relatively young T2DM patients suffer less from serious diabetes-related physical or medical restrictions [13,14] or from other chronic diseases or disabilities [15,16]. Previous research has shown that this applied with regard to lifestyle programs in other target populations [22,23,24,25]
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