Patient Preferences for Pain Management in Advanced Cancer: Results from a Discrete Choice Experiment
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 d...
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| Veröffentlicht in: | The patient : patient-centered outcomes research 2017-10, Vol.10 (5), p.643-651 |
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| creator | Meads, David M. O’Dwyer, John L. Hulme, Claire T. Chintakayala, Phani Vinall-Collier, Karen Bennett, Michael I. |
| description | 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. |
| doi_str_mv | 10.1007/s40271-017-0236-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1883182403</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1883182403</sourcerecordid><originalsourceid>FETCH-LOGICAL-c415t-5759f5322d4db5919737dc73ddaade7200ddda1306291dde39adae89ed2de49c3</originalsourceid><addsrcrecordid>eNp1kU1LxDAQhoMofv8ALxLw4qWaSZqm8Sbr-gGKi-g5ZJvpWtlt16SV9d-b0lVE8DQT3mc-Mi8hR8DOgDF1HlLGFSQMVMK4yJLVBtkFUHkCWQabP7kUO2QvhDfGsihk22SH5yJLRS53CU5sW2Hd0onHEj3WBQZaNp5ObFXTB1vbGS56Pb4u3YeNuqOjPvgL-oShm7eR982CWnpVhcJji3T02lQF0vFqib7qqw_IVmnnAQ_XcZ-8XI-fR7fJ_ePN3ejyPilSkG0ildSlFJy71E2lBq2EcoUSzlnrUHHGXExBsIxrcA6Fts5irtFxh6kuxD45HfouffPeYWjNIu6E87mtsemCgTwXkPOUiYie_EHfms7XcTsDWrOUc5nLSMFAFb4JIZ7ILOOPrP80wEzvgRk8MNED03tgVrHmeN25my7Q_VR8Hz0CfABClOoZ-l-j_-36BUt8kgU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1990422585</pqid></control><display><type>article</type><title>Patient Preferences for Pain Management in Advanced Cancer: Results from a Discrete Choice Experiment</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Meads, David M. ; O’Dwyer, John L. ; Hulme, Claire T. ; Chintakayala, Phani ; Vinall-Collier, Karen ; Bennett, Michael I.</creator><creatorcontrib>Meads, David M. ; O’Dwyer, John L. ; Hulme, Claire T. ; Chintakayala, Phani ; Vinall-Collier, Karen ; Bennett, Michael I.</creatorcontrib><description>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.</description><identifier>ISSN: 1178-1653</identifier><identifier>EISSN: 1178-1661</identifier><identifier>DOI: 10.1007/s40271-017-0236-x</identifier><identifier>PMID: 28364385</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adult ; Age ; Aged ; Aged, 80 and over ; Analgesics ; Cancer Pain - therapy ; Choice Behavior ; Communication ; Decision Support Techniques ; Experiments ; Female ; Focus Groups ; Health Administration ; Health care expenditures ; Health care policy ; Health Economics ; Health Expenditures ; Humans ; Logistic Models ; Lung cancer ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Narcotics ; Neoplasm Staging ; Original Research Article ; Pain management ; Pain Management - methods ; Palliative care ; Palliative Care - methods ; Patient Education as Topic ; Patient Preference - psychology ; Patients ; Pharmacoeconomics ; Pharmacoeconomics and Health Outcomes ; Preferences ; Professional-Patient Relations ; Public Health ; Qualitative research ; Quality of Life ; Quality of Life Research ; Time Factors ; Young Adult</subject><ispartof>The patient : patient-centered outcomes research, 2017-10, Vol.10 (5), p.643-651</ispartof><rights>Springer International Publishing Switzerland 2017</rights><rights>Copyright Springer Science & Business Media Oct 2017</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c415t-5759f5322d4db5919737dc73ddaade7200ddda1306291dde39adae89ed2de49c3</citedby><cites>FETCH-LOGICAL-c415t-5759f5322d4db5919737dc73ddaade7200ddda1306291dde39adae89ed2de49c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s40271-017-0236-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s40271-017-0236-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28364385$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Meads, David M.</creatorcontrib><creatorcontrib>O’Dwyer, John L.</creatorcontrib><creatorcontrib>Hulme, Claire T.</creatorcontrib><creatorcontrib>Chintakayala, Phani</creatorcontrib><creatorcontrib>Vinall-Collier, Karen</creatorcontrib><creatorcontrib>Bennett, Michael I.</creatorcontrib><title>Patient Preferences for Pain Management in Advanced Cancer: Results from a Discrete Choice Experiment</title><title>The patient : patient-centered outcomes research</title><addtitle>Patient</addtitle><addtitle>Patient</addtitle><description>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.</description><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analgesics</subject><subject>Cancer Pain - therapy</subject><subject>Choice Behavior</subject><subject>Communication</subject><subject>Decision Support Techniques</subject><subject>Experiments</subject><subject>Female</subject><subject>Focus Groups</subject><subject>Health Administration</subject><subject>Health care expenditures</subject><subject>Health care policy</subject><subject>Health Economics</subject><subject>Health Expenditures</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Lung cancer</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Narcotics</subject><subject>Neoplasm Staging</subject><subject>Original Research Article</subject><subject>Pain management</subject><subject>Pain Management - methods</subject><subject>Palliative care</subject><subject>Palliative Care - methods</subject><subject>Patient Education as Topic</subject><subject>Patient Preference - psychology</subject><subject>Patients</subject><subject>Pharmacoeconomics</subject><subject>Pharmacoeconomics and Health Outcomes</subject><subject>Preferences</subject><subject>Professional-Patient Relations</subject><subject>Public Health</subject><subject>Qualitative research</subject><subject>Quality of Life</subject><subject>Quality of Life Research</subject><subject>Time Factors</subject><subject>Young Adult</subject><issn>1178-1653</issn><issn>1178-1661</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU1LxDAQhoMofv8ALxLw4qWaSZqm8Sbr-gGKi-g5ZJvpWtlt16SV9d-b0lVE8DQT3mc-Mi8hR8DOgDF1HlLGFSQMVMK4yJLVBtkFUHkCWQabP7kUO2QvhDfGsihk22SH5yJLRS53CU5sW2Hd0onHEj3WBQZaNp5ObFXTB1vbGS56Pb4u3YeNuqOjPvgL-oShm7eR982CWnpVhcJji3T02lQF0vFqib7qqw_IVmnnAQ_XcZ-8XI-fR7fJ_ePN3ejyPilSkG0ildSlFJy71E2lBq2EcoUSzlnrUHHGXExBsIxrcA6Fts5irtFxh6kuxD45HfouffPeYWjNIu6E87mtsemCgTwXkPOUiYie_EHfms7XcTsDWrOUc5nLSMFAFb4JIZ7ILOOPrP80wEzvgRk8MNED03tgVrHmeN25my7Q_VR8Hz0CfABClOoZ-l-j_-36BUt8kgU</recordid><startdate>20171001</startdate><enddate>20171001</enddate><creator>Meads, David M.</creator><creator>O’Dwyer, John L.</creator><creator>Hulme, Claire T.</creator><creator>Chintakayala, Phani</creator><creator>Vinall-Collier, Karen</creator><creator>Bennett, Michael I.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20171001</creationdate><title>Patient Preferences for Pain Management in Advanced Cancer: Results from a Discrete Choice Experiment</title><author>Meads, David M. ; O’Dwyer, John L. ; Hulme, Claire T. ; Chintakayala, Phani ; Vinall-Collier, Karen ; Bennett, Michael I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c415t-5759f5322d4db5919737dc73ddaade7200ddda1306291dde39adae89ed2de49c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Age</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analgesics</topic><topic>Cancer Pain - therapy</topic><topic>Choice Behavior</topic><topic>Communication</topic><topic>Decision Support Techniques</topic><topic>Experiments</topic><topic>Female</topic><topic>Focus Groups</topic><topic>Health Administration</topic><topic>Health care expenditures</topic><topic>Health care policy</topic><topic>Health Economics</topic><topic>Health Expenditures</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Lung cancer</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Narcotics</topic><topic>Neoplasm Staging</topic><topic>Original Research Article</topic><topic>Pain management</topic><topic>Pain Management - methods</topic><topic>Palliative care</topic><topic>Palliative Care - methods</topic><topic>Patient Education as Topic</topic><topic>Patient Preference - psychology</topic><topic>Patients</topic><topic>Pharmacoeconomics</topic><topic>Pharmacoeconomics and Health Outcomes</topic><topic>Preferences</topic><topic>Professional-Patient Relations</topic><topic>Public Health</topic><topic>Qualitative research</topic><topic>Quality of Life</topic><topic>Quality of Life Research</topic><topic>Time Factors</topic><topic>Young Adult</topic><toplevel>online_resources</toplevel><creatorcontrib>Meads, David M.</creatorcontrib><creatorcontrib>O’Dwyer, John L.</creatorcontrib><creatorcontrib>Hulme, Claire T.</creatorcontrib><creatorcontrib>Chintakayala, Phani</creatorcontrib><creatorcontrib>Vinall-Collier, Karen</creatorcontrib><creatorcontrib>Bennett, Michael I.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>The patient : patient-centered outcomes research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Meads, David M.</au><au>O’Dwyer, John L.</au><au>Hulme, Claire T.</au><au>Chintakayala, Phani</au><au>Vinall-Collier, Karen</au><au>Bennett, Michael I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patient Preferences for Pain Management in Advanced Cancer: Results from a Discrete Choice Experiment</atitle><jtitle>The patient : patient-centered outcomes research</jtitle><stitle>Patient</stitle><addtitle>Patient</addtitle><date>2017-10-01</date><risdate>2017</risdate><volume>10</volume><issue>5</issue><spage>643</spage><epage>651</epage><pages>643-651</pages><issn>1178-1653</issn><eissn>1178-1661</eissn><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.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>28364385</pmid><doi>10.1007/s40271-017-0236-x</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Age Aged Aged, 80 and over Analgesics Cancer Pain - therapy Choice Behavior Communication Decision Support Techniques Experiments Female Focus Groups Health Administration Health care expenditures Health care policy Health Economics Health Expenditures Humans Logistic Models Lung cancer Male Medicine Medicine & Public Health Middle Aged Narcotics Neoplasm Staging Original Research Article Pain management Pain Management - methods Palliative care Palliative Care - methods Patient Education as Topic Patient Preference - psychology Patients Pharmacoeconomics Pharmacoeconomics and Health Outcomes Preferences Professional-Patient Relations Public Health Qualitative research Quality of Life Quality of Life Research Time Factors Young Adult |
| title | Patient Preferences for Pain Management in Advanced Cancer: Results from a Discrete Choice Experiment |
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