Discrete Choice Experiment Methodology Research Articles

Assessing Preferences of Patients with Chronic Spontaneous Urticaria for Injectable Treatment Profiles.

In the context of injectable biologic products approved or in development for chronic spontaneous urticaria (CSU), it is important to capture which treatment attributes matter most to patient and what trade-offs patients are willing to make. The CHOICE-CSU study aimed to quantify patient preferences toward injectable treatment attributes among patients with CSU, inadequately controlled by H1-antihistamines. This was a two-phase cross-sectional patient preference study in adult patients with a diagnosis of CSU, inadequately controlled by H1-antihistamines. A qualitative phase collected patients' insights and relevant treatment attributes that mattered to them, and the outputs were used for the quantitative phase to create the actual injectable treatment profiles with attributes and levels such as: efficacy, safety, and mode of administration. The quantitative phase used discrete choice experiment (DCE) methodology. Eligible patients were asked to make hypothetical choices between 12 treatment profile pairs, created by Sawtooth SoftwareTM. The DCE data were analyzed using hierarchical Bayesian logistic regression models, enabling the quantification of the relative importance of each attribute/level during the decision-making process. A total of 450 respondents participated in the DCE. The key attributes driving respondent preference amongst injectable treatment options were type of administration device (relative importance 18.5%), complete control of urticaria (relative importance 17.4%), and resolution of angioedema (relative importance 16.4%). Keeping all other attributes and levels equal, the predicted choice share was higher for a profile with an auto-injector versus one with a pre-filled syringe (72.9% versus 27.1%). The CHOICE-CSU study is the first study to provide a quantitative assessment of preferences that patients with CSU, inadequately controlled by H1-antihistamines, have for injectable treatment attributes. Symptom-free periods are the most important overriding therapy goal for patients, and patients will accept some inconveniences, such as administration mode, to achieve this. Additionally, when efficacy is equivalent, administration ease of injectable therapies is valued by patients. As new CSU oral treatment options emerge, additional testing of patient preference toward oral treatments will be required.

How to keep teachers in a profession in times of budget shortages?

ABSTRACT This paper examines teachers’ preferences for working conditions that affect job satisfaction. It addresses the credibility crisis facing the teaching profession in many nations due to low wages and poor working conditions. Beyond income, teachers appreciate other elements that can compensate for their relatively low pay, potentially relieving the strain on national budgets compared to wage increases. Using the discrete choice experiment methodology, this study investigated teachers’ preferences for job-related characteristics that policymakers can directly alter and incorporate into the compensation system. Teachers demonstrated a strong preference for access to equipment, private medical treatment, theatre tickets, and free public transit, valuing these attributes higher than their current market price, suggesting promising policy avenues. These findings may provide evidence for drafting effective teachers’ contracts and use the Discrete Choice Experiment (DCE) as the school-level tool for motivation management.

Preferences for breast cancer screening: Results of a discrete choice experiment.

This study aimed to assess the preferences of breast cancer patients in China for screening services using a discrete choice experiment (DCE) and latent class modeling (LCM). The findings are intended to inform the development of more patient-centered screening programs. A cross-sectional, hospital-based survey employing discrete choice experiment methodology. A total of 278 breast cancer patients were recruited from the Department of Thyroid and Breast Surgery at a tertiary hospital in Guizhou Province. The study evaluated key attributes of screening services, including screening frequency, medical staff experience, referral sources, and out-of-pocket costs, through a DCE questionnaire. A mixed logit model was applied to assess overall patient preferences, while LCM was used to explore heterogeneity among patient subgroups. The development of the DCE questionnaire involved focus group discussions to ensure the relevance of attributes. The analysis revealed that screening frequency, medical staff experience, and out-of-pocket costs were the most significant factors influencing patient preferences. Patients exhibited a strong preference for annual screenings (β=-1.622, p<0.001) and for screening by experienced medical staff (β=2.216, p<0.001). Additionally, lower out-of-pocket costs significantly enhanced willingness to participate (β=-0.211, p<0.05). LCM analysis identified two distinct patient subgroups: "process-driven" patients, who prioritized lower costs and multi-channel referral options, and "efficiency-driven" patients, who valued timely service and experienced staff. This study emphasizes the diverse preferences of breast cancer patients for screening services and suggests that personalized screening programs could better meet the needs of different patient subgroups. Developing flexible, patient-centered screening programs will be essential to improving participation and satisfaction with breast cancer screening in China. Practical challenges in implementing such personalized approaches should be considered in future policy development.

A discrete choice experiment with health professions trainees to improve the urban-rural health care access disparity in Appalachia: Study protocol.

Globally, those who live in rural areas experience significant barriers to accessing health care due to a maldistribution of health care providers. Those who live in rural areas in the Appalachian region of the United States face one of the worst shortages of health care providers despite experiencing more complex health needs compared to Americans in more affluent, urban areas. Prior research has failed to identify effective solutions to narrow the provider maldistribution, despite it being a policy focus for decades. More work is needed to better understand the complex, multidimensional process in which health care providers select jobs and how job, community, and providers' intrapersonal characteristics influence job selection. This paper is a protocol for a study aimed at identifying effective policies and incentives to improve recruitment of healthcare providers for their first job in rural Appalachia. We will use rigorous, theoretically grounded discrete choice experiment methodology (DCE) to accomplish the study's objective. The main outcome will be the relative importance of alternative community and job characteristics for trainees' choices of jobs in rural Appalachia. secondary outcomes of interest will be trade-offs that these trainees make when selecting a job, described in the form of marginal rates of substitution (mRS). Participants include medical residents and fellows, PA students and NP students in their final year of training. The choice context will be the recruitment of these trainees for their first job. Data will be analyzed using mixed logit analysis. Results from this DCE will improve our understanding of the job selection process for health care providers. The identification and prioritization of predictors of trainees' rural job choices will allow for the development of policies and incentives that will enable policymakers and health care systems to recruit more providers to rural and underserved areas.

A web-based video messaging intervention for suicide prevention in men: study protocol for a five-armed randomised controlled trial

BackgroundMore than 50% of people who die by suicide have not been in contact with formal mental health services. The rate of people who fly ‘under the radar’ of mental health services is higher among men than women, indicating a need to improve engagement strategies targeted towards men who experience suicidal thoughts and/or behaviours. In Australia, a range of mental health support services exist, designed specifically for men, yet, a substantial proportion of men do not use these services. The aim of this study is to evaluate whether a brief online video-based messaging intervention is an effective approach for encouraging men with suicidal thoughts and/or behaviours to engage with existing support services.MethodsInformed by a literature review, surveys, and consultation with men with a lived experience of suicidal thoughts and/or behaviours, we designed five video-based messages that will be used in this five-arm randomised controlled trial. A total of 380 (76 per arm) men aged 18 years or older with suicidal thoughts who are not currently accessing formal mental health services will be recruited online and randomly assigned to watch one of the five web-based video messages. After viewing the video, men will be presented with information about four existing Australian support services, along with links to these services. The primary outcome will be help-seeking, operationalised as a click on any one of the four support service links, immediately after viewing the video. Secondary outcomes include immediate self-reported help-seeking intentions in addition to self-reported use of the support services during a 1-week follow-up period. We will also use the Discrete Choice Experiment methodology to determine what aspects of support services (e.g. low cost, short appointment wait times) are most valued by this group of men.DiscussionThis study is the first to evaluate the effectiveness of a brief web-based video messaging intervention for promoting engagement with existing support services among men with suicidal thoughts who are not currently receiving formal help. If found to be effective, this would represent a scalable, cost-effective approach to promote help-seeking for this at-risk population. Limitations and strengths of this study design are discussed.

Elicitation of societal preferences for chronic lymphocytic leukemia’s treatments: a discrete choice experiment

The overall value of treatments for chronic lymphocytic leukemia (CLL) depends on several factors, including preferences of the general population, who contributes to the financing of health systems. This study investigated societal preferences for attributes of CLL treatments in Italy. An online large-scale survey was designed using a discrete choice experiment (DCE) methodology and delivered to the Italian adult general population. Ten treatment attributes were identified, covering efficacy, safety, operational aspects and (hypothetical) out-of-pocket cost. DCE data were analyzed using a mixed logit regression model, estimating the willingness-to-pay for attribute levels’ change. The general population significantly preferred more effective treatments, with shorter duration, administered orally rather than orally + intravenously. Changes in therapy duration, frequency of checkups and organ damage risk had the greatest impact on preferences. The integration of societal preferences in the value judgments of CLL therapies may help health authorities in establishing priority setting and taking pricing-reimbursement decisions.

Abstract PO1-18-01: Patient Preferences for HR+/HER2- Metastatic Breast Cancer Treatments in Italy: A Qualitative Assessment

Abstract Objectives: Factors that influence treatment preferences of patients with hormone receptor-positive/HER2-negative (HR+/HER2-) metastatic breast cancer (mBC) are being investigated using discrete choice experiment (DCE) methodology. Appropriate attributes for the ongoing quantitative online survey phase were identified by this initial qualitative pilot study. Methods: To generate hypotheses and inform variables of the quantitative survey, the pilot phase consisted in online telephone interviews with patients with a diagnosis of Stage IV HR+/HER2- breast cancer at various stages of treatment. Interviews focused on exploring patients' perspectives on their interaction with physicians, preferences, and treatment experiences. Transcripts were coded using NVivo software to identify key themes. The ongoing DCE online survey aims to recruit patients meeting the same selection criteria as in the qualitative phase, also at various stages of treatment. Results: Fifteen mBC patients (median age, 43 years [range, 29-64]), including nine chemotherapy-treated and six without chemotherapy exposure, were enrolled in the pilot qualitative study. Eight and four patients reported receiving little information about their treatment plan and their risk status beyond the risk of relapse, respectively. Most participants did not know what to expect from their therapy but expressed trust in their physician’s decision in terms of treatment goals. Few patients (n=3) looked for a second opinion before starting treatment. Four out of fifteen patients declared that they were actively involved in their treatment plan decision, although all relied on their physician’s knowledge and decision. Reduced symptoms and improved quality of life (QoL) were patients’ main treatment goals, and side-effects and efficacy of treatment were their main concerns. When asked about the degree of acceptability of certain side effects, some participants considered hair loss and vomiting as unacceptable side effects, regardless of severity, while others considered them to be the most acceptable. This discrepancy is to be interpreted in the light of participants’ own treatment journey. Severity and duration of side-effects were mentioned by three patients as acceptability factors. In a choice task, patients were asked to express preferences between two hypothetical treatments. Efficacy (n=9) and administration mode (n=6) were spontaneously deemed important for treatment selection. While assessing the difference in risk between the two hypothetical treatments, ten patients explained that the main choice feature was extended progression-free survival (PFS) rate. Risk of infection and neutropenia (n=12) were concerns expressed by most patients in the post-COVID-19 period. Considering their substantial impact on QoL, alopecia (n=9) and vomiting (n=9) were presented by patients as particularly important, regardless of their degree of severity; whereas almost all patients reported that only severe fatigue (n=12), diarrhea (n=13) or nausea (n=13) would be an issue. These results allowed selection of the following attributes for further quantification of their preference weights in a DCE: PFS, risk of neutropenia, risk of alopecia, risk of vomiting, risk of diarrhea, risk of grade 3/4 side effects and mode of administration. Conclusions: This qualitative pilot study allowed for identification of what matters most to patients when selecting a treatment for mBC, which will be further assessed in the DCE. It also highlighted the need of patients with HR+/HER2- mBC for information about their treatment, potential side-effects, and health management. This research suggests that there is a need for patients to be more involved in treatment plans, and that taking patient preferences into account may help improve the treatment selection experiences. Citation Format: Grazia Arpino, Carmine De Angelis, Lorenzo Gerratana, Matteo Lambertini, Sarah Igidbashian, Martina Bellini, Serena Giuntoli, Xavier Guillaume, Julie Behillil, Claire Graziani-Taugeron. Patient Preferences for HR+/HER2- Metastatic Breast Cancer Treatments in Italy: A Qualitative Assessment [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-18-01.

Quantifying preferences for urea cycle disorder treatments using a discrete choice experiment

Aims Urea cycle disorders (UCDs) can cause ammonia accumulation and central nervous system toxicity. Nitrogen-binding medications can be efficacious, but certain attributes may negatively impact adherence. This study sought to quantify the administration-related attributes influencing overall prescription selection and patient adherence. Methods A web-based, quantitative survey including discrete choice experiment (DCE) methodology captured responses from health care providers for patients with UCDs. A series of hypothetical treatment profile sets with attributes such as route of administration, taste/odor, preparation instructions, packaging, dose measurement, and weight use restrictions were presented. From 16 sets of 3 hypothetical product profiles, respondents evaluated attributes most preferred for prescription selection or patient adherence. Attributes assumed a higher overall preference if relative importance (RI) scores were >16.67% (the value if all attributes were of equal importance). Preference weight scores were assessed. A nine-point Likert scale assessed respondent attitudes, such as satisfaction. Results A total of 51 respondents completed the survey. Respondents reported dissatisfaction with current treatments (mean [SD] = 5.4 [1.7]). For prescription selection, four attributes achieved RI >16.67%: taste/odor (24%), weight restrictions (21%), preparation instructions (18%), and route of administration (17%). For adherence, three attributes related to administration achieved RI >16.67%: taste/odor (28%), preparation instructions (21%), and route of administration (17%). Preference weights for “taste/odor masked” were higher than “not taste/odor masked” for prescription selection (mean [SD]; 1.52 [1.10] vs −1.52 [1.10]) and treatment adherence (73.8 [55.2] vs −73.8 [55.2]). Limitations This study contained a relatively small sample size. Survey respondent selection, the use of hypothetical product profiles, and exclusion of non-pharmacologic treatment options could have contributed to potential biases. Conclusions Among attributes tested, taste/odor was the most important attribute influencing overall preference for both prescribing and patient adherence, with taste/odor masking preferred. Optimizing nitrogen-binding medications through masking taste/odor may support improved patient adherence and outcomes in UCDs.

Keeping up with the Kardashians: Evidence from a choice experiment with a nationally representative sample

This study aims at investigating preferences regarding nominal income, standing in income distribution, and income change over time. We use a nationally representative sample and employ the Discrete Choice Experiment methodology in the random utility framework. We estimate trade-offs between the absolute income, income change over time, and relative standing in income distribution. The general finding is that the importance of relative income is greater for wealthier respondents; moreover, respondents are willing to sacrifice a large amount of their overall well-being for a constant upward trend in their earnings during their life cycle. Males are particularly sensitive to relative income: they are willing to “burn” nominal money to reach a higher status, also controlling for wealth. Our study provides evidence for the driving force behind the pursuit of wealth in more affluent countries. Despite high aggregate consumption levels, there is a concern for status as measured by relative standing in society and own income change over time.

Exploring employment preferences of nurses to improve retention in rural China

BackgroundThe scarcity of nurses in rural China deserves serious consideration in light of the widening gap in health outcomes between rural and urban populations. The outflow of primary care nurses suggests the value of examining their employment preferences to identify possible effective incentives for their retention. MethodsOur research used discrete choice experiment methodology designed to quantitatively measure the relative importance of various job attributes valued by primary care nurses using conditional logit and mixed logit models. Willingness to pay and uptake rates were also calculated. ResultsA total of 1744 registered nurses in township health centres were surveyed. Participants considered all the job attributes included in the study to be significant, with pay increases demonstrating the greatest potential to improve the retention of nurses. Among the non-monetary aspects of work, nurse–patient relationships, bianzhi (positions allocated to each unit by the Chinese government with special benefits) and educational opportunities ranked highest in importance for respondents. Responses to hypothetical policy proposals suggest that incentive packages are also likely to be effective. ConclusionsPolicy making regarding rural nurses' retention is an important undertaking that requires an evidence-based approach. Our findings provide a range of policy options that shed light on effective retention strategies. Tailoring policy incentives to primary care nurses is also necessary.

OP02 The Use Of Discrete Choice Experiments For Measuring Patient Preferences In Health Technology Assessment

IntroductionUnderstanding patient preferences and the demand for healthcare interventions and technology is critical for health technology assessment (HTA). New health technologies have potential for savings and increased efficiency but even the most cost-effective and efficacious interventions can fail if patient preferences are not properly accounted for. Patient preferences in HTA are primarily limited to representation in appraisal committees; however, more robust methods are available and should be incorporated into the assessment of interventions.MethodsUsing data from three discrete choice experiments (DCEs), we reflect on the importance of patient preferences in the design of healthcare interventions. We draw insights from three studies which investigated preferences relating to HIV self-testing amongst long distance truck drivers in Kenya; differentiated antiretroviral therapy services amongst stable HIV patients in Zimbabwe; and tuberculosis preventive therapy for children in Eswatini.ResultsWe highlight three key findings. First, understanding patient preferences is crucial when designing services, and providers sometimes underestimate behavioural barriers and overestimate the extent to which people are motivated simply by health benefits. Optimism is often driven by evidence showing high acceptability, but when preference structures are incorporated in intervention design, there are important insights into how patients plan to utilize services. Second, trade-offs matter in determining which characteristics are perceived to be most important to patients – a key strength of the DCE methodology. Understanding of these trade-offs can help prioritize which characteristics of interventions to target. Finally, disentangling the effect of different characteristics of service delivery models on preferences is important for rethinking how interventions are delivered. If services are designed to better align with preferences, implementers can ensure new interventions have the desired effect on health and economic outcomes.ConclusionsThese findings highlight the value of behavioural economic approaches for investigating preferences for health interventions and providing insights into the demand for services, which must feed into the HTA analyses. Incorporating DCEs into HTA is inexpensive and provides robust data for improving HTA.

Surgeon preference for treatment allocation in older people facing major gastrointestinal surgery: an application of the discrete choice experiment methodology.

Variation in major gastrointestinal surgery rates in the older population suggests heterogeneity in surgical management. A higher prevalence of comorbidities, frailty and cognitive impairments in the older population may account for some variation. The aim of this study was to determine surgeon preference for major surgery versus conservative management in hypothetical patient scenarios based on key attributes. A survey was designed according to the discrete choice methodology guided by a separate qualitative study. Questions were designed to test for associations between key attributes (age, comorbidity, urgency of presentation, pathology, functional and cognitive status) and treatment preference for major gastrointestinal surgery versus conservative management. The survey consisting of 18 hypothetical scenarios was disseminated electronically to UK gastrointestinal surgeons. Binomial logistic regression was used to identify associations between the attributes and treatment preference. In total, 103 responses were received after 256 visits to the questionnaire site (response rate 40.2%). Participants answered 1847 out of the 1854 scenarios (99.6%). There was a preference for major surgery in 1112/1847 (60.2%) of all scenarios. Severe comorbidities (OR 0.001, 95% CI 0.000-0.030; P= 0.000), severe cognitive impairment (OR 0.001, 95% CI 0.000-0.033; P= 0.000) and age 85 years and above (OR 0.028, 95% CI 0.005-0.168; P= 0.000) were all significant in the decision not to offer major gastrointestinal surgery. This study has demonstrated variation in surgical treatment preference according to key attributes in hypothetical scenarios. The development of fitness-stratified guidelines may help to reduce variation in surgical practice in the older population.

Using a discrete choice experiment to develop a decision aid tool to inform the management of persistent pain in pharmacy: a protocol for a randomised feasibility study

IntroductionIn an era of personalised healthcare, it has become increasingly important to elicit individual-level preferences. While discrete choice experiments (DCEs) are widely used to measure patient preferences in the delivery...

PCR85 Brand or Generic: Conjoint Based Analysis for Preferences of Egyptian Nationally Insured Coronary Heart Disease Patients

Patient preferences for branded and generic drugs have been the subject of extensive research; however, few studies focused on patients suffering from severe illnesses like coronary heart disease (CHD). We did not find studies that measured the preference weights of different classes’ brands using the discrete choice experiment methodology.

Designing Better Public Transport: Understanding Mode Choice Preferences Following the COVID-19 Pandemic

Transport behaviour has evidently changed following the COVID-19 pandemic, with lower usage across multiple modes of public transport and an increasing use of private vehicles. This is problematic as private vehicle use has been linked to an increase in traffic-related air pollutants, and consequently global warming and health-related issues. Hence, it is important to capture transport mode choice preferences following the pandemic, so that potential service changes can be made to address the lower usage. In total, 1138 respondents took part in an online discrete choice experiment methodology to quantify the utility of public transport service attributes in decision making around the choice of public transport. The data resulted in the development of three models using a multinomial logit model in R. For respondents on personal or commuting journeys, the mode of transport had no effect on utility. Results found that fare cost was the most important factor driving transport mode preference, when a range of choices were available. Following this, keeping fare cost consistent, faster journey times were preferred to stronger access to transport (i.e., through the provision of more bus stops/stations). The provision of operational relevant information to the journey was only significantly valued by commuters and travellers who could claim their journey as a business expense. Finally, when cost became less relevant (i.e., for travellers on expensed journeys), there was a significantly strong preference for taxi and road vehicle transport over all other transport modes. The results from this empirical research are discussed and the implications of recent transport policy are discussed, and recommendations of public transport service design are made.

What attracts teachers to rural and remote schools? Incentivising teachers’ employment choices in New South Wales

Staffing rural and regional schools remains an intractable problem. This study identifies effective incentives for attracting teachers to difficult-to-staff rural and remote schools in New South Wales (NSW), Australia. Compared to their urban counterparts, students in these schools are disadvantaged by teacher staff shortages, inexperience and attrition. The research investigated the ability for existing incentives of the NSW Department of Education, other education systems and other professions to attract professionals to rural and remote appointments using a discrete choice experiment methodology. The findings identify ways of attracting teachers of differing levels of experience and commitment to work in such areas.

POSA331 Patient Preferences for Diabetes Management in Spain - A Discrete Choice Experiment

To describe the preferences of individuals with diabetes mellitus (DM) for the attributes of DM medications in Spain. The project was conducted in four phases (A-D). Firstly, in phase A, a Steering Committee reviewed, selected, and validated a total of 18 attributes and its corresponding levels for treating DM. The attributes were classified into four categories: health outcomes, adverse events, treatment characteristics and cost of treatment. Secondly, in phase B, a questionnaire based on Discrete Choice Experiment (DCE) methodology was developed. Subsequently, in phase C, adult people with DM members of associations of DM, were asked to complete an online DCE survey between May and September 2020. Finally, in phase D, the results obtained were analysed and contextualized in a deliberative process. Of the 238 participants who completed the questionnaire, 231 were analysed (mean age, 58 years; males, 62%; mean HbA1c level, 7.00%). The DCE results showed that the best-valued category was health outcomes (39.67%), followed by adverse events (26.85%), treatment characteristics (21.70%) and treatment costs (11.77%). The 10 attributes with the highest relative importance value had a significant effect on participants’ choice (p<0.05): blood pressure reduction (12.82%), hypoglycaemia (12.77%), HbA1c level reduction (8.54%), cost of the medication (8.13%), needle/tablet size (7.20%), weight change (6.72%), risk of genitourinary infections (6.36%), gastrointestinal problems (5.82%), improved kidney function (5.53%) and administration route (5.41%). People with DM prefer a treatment that generates benefits in measurable health effects (reducing blood pressure and HbA1c level, while not risking hypoglycaemia) and an administration route. To consider patients’ preference, above all in people with chronic pathologies could generate better clinical results and therapeutic adherence, reducing morbidity, mortality, and disease burden and improving their quality of life.

Generation Z willingness to pay for sustainable apparel: the influence of labelling for origin and eco-friendly material

The purpose of this study is to identify the willingness to pay (WTP) and trade-off that Vietnamese generation Z consumers could make when purchasing eco-friendly apparel. This research uses the Discrete Choice Experiment methodology to measure consumers' WTP and how consumers trade off among different attributes, including eco-friendly, origin, manufacturing technology, and materials. The results show that generation Z consumers are willing to pay for organic label products at a higher price of 21.22% and eco-friendly label items at a higher price of 37.72%. Consumers who have a higher level of corporate social responsibility (CSR) awareness and higher income are willing to pay more for organic and ecofriendly label apparel. They were least willing to purchase apparel that is made in China, while they see no difference between T-shirts made in Vietnam and in other countries except China. Consumers in the current study were more willing to purchase eco-friendly as compared to organic apparel. The findings suggest that enterprises should consider the language used when communicating with consumers. Also, consumers prefer products made in Vietnam, suggesting the promotion of domestic manufacturing through in-depth branding, product positioning, and promotions. The results also confirm that the application of CSR in enterprises is the right and necessary step to be taken for businesses to develop in a sustainable integration world.

Patient Preferences for Pharmacological Diabetes Treatment Among People with Diabetes in Spain: A Discrete Choice Experiment.

IntroductionThe aim of the project was to describe the preferences related to the medication attributes of people with diabetes mellitus (DM) treated in Spain.MethodsThe project was carried out in four different phases. In phase A, a Steering Committee defined and selected a total of 18 attributes for treating DM and grouped them into four categories: health outcomes, adverse events, treatment characteristics and cost of treatment. In phase B, a questionnaire according to a discrete choice experiment (DCE) methodology was developed. In phase C, the online DCE survey was sent to members of associations of people with DM from the Spanish Diabetes Federation (FEDE). Finally, in phase D, the results were discussed in a deliberative process.ResultsOf the 238 participants who completed the questionnaire (May–September 2020), 231 were included (mean age, 58 years; males, 62%). The DCE results showed that the best-valued category was health outcomes (39.67%), followed by adverse events (26.85%), treatment characteristics (21.70%) and treatment costs (11.77%). Ten of 18 attributes had a significant effect on participants’ choice (p < 0.05) and the highest relative importance value: blood pressure reduction (12.82%), hypoglycaemia (12.77%), HbA1c level reduction (8.54%), cost of the medication (8.13%), needle/tablet size (7.20%), weight change (6.72%), risk of genitourinary infections (6.36%), gastrointestinal problems (5.82%), improved kidney function (5.53%) and administration route (5.41%).ConclusionsPeople with DM prefer a treatment that generates benefits in measurable health effects (reducing blood pressure and HbA1c level, while not risking hypoglycaemia) and a convenient route of administration. Considering the preferences of people with DM could generate better clinical results and therapeutic adherence, reducing morbidity, mortality and disease burden.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13300-021-01178-9.

What Constitutes Preferred Long-Term Care Provided in Residential Aged Care Facilities? An Empirical Comparison of the Preferences of the General Population, Residents, and Family Members

ObjectivesRelatively few studies to date have examined the preferences of members of the general population as potential future consumers of long-term aged care services. This study aimed to use discrete choice experiment methodology to compare the preferences of 3 groups: the general population, residents, and family members of people living in long-term aged care. MethodsA total of 6 salient attributes describing the physical and psychosocial care in long-term residential aged care were drawn from qualitative research with people with a lived experience of aged care and were used to develop the discrete choice experiment questionnaire. The 6 attributes included: the level of time care staff spent with residents, homeliness of shared spaces, the homeliness of their own rooms, access to outside and gardens, frequency of meaningful activities, and flexibility with care routines. The questionnaire was administered to 1243 respondents including consumers (residents [n = 126], family member carers [n = 416]), and members of the general population (n = 701). ResultsFor both the general population and resident samples, having their own room feeling “home-like” exhibited the largest impact upon overall preferences. For the family member sample, care staff being able to spend enough time exhibited the largest impact. Tests of poolability indicated that the resident and general population samples estimates could be pooled. The null hypothesis of equal parameters between the groups was rejected for the family members, indicating significant differences in preferences relative to the resident and the general population samples. ConclusionsThis study illustrates that preferences for residential aged care delivery may vary depending upon perspective and experience.