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Patient Preferences for Pain Management in Advanced Cancer: Results from a Discrete Choice Experiment

Author

Listed:
  • David M. Meads

    (University of Leeds)

  • John L. O’Dwyer

    (University of Leeds)

  • Claire T. Hulme

    (University of Leeds)

  • Phani Chintakayala

    (University of Leeds)

  • Karen Vinall-Collier

    (University of Leeds
    University of Leeds)

  • Michael I. Bennett

    (University of Leeds)

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.

Suggested Citation

  • David M. Meads & John L. O’Dwyer & Claire T. Hulme & Phani Chintakayala & Karen Vinall-Collier & Michael I. Bennett, 2017. "Patient Preferences for Pain Management in Advanced Cancer: Results from a Discrete Choice Experiment," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 10(5), pages 643-651, October.
    • Handle: RePEc:spr:patien:v:10:y:2017:i:5:d:10.1007_s40271-017-0236-x
    DOI: 10.1007/s40271-017-0236-x
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    References listed on IDEAS

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    1. Mickael Bech & Dorte Gyrd‐Hansen, 2005. "Effects coding in discrete choice experiments," Health Economics, John Wiley & Sons, Ltd., vol. 14(10), pages 1079-1083, October.
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    Cited by:

    1. Alene Sze Jing Yong & Yi Heng Lim & Mark Wing Loong Cheong & Ednin Hamzah & Siew Li Teoh, 2022. "Willingness-to-pay for cancer treatment and outcome: a systematic review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(6), pages 1037-1057, August.

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