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Does being exposed to an educational tool influence patient preferences?: The influence of an educational tool on patient preferences assessed by a discrete choice experiment
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.ORCID iD: 0000-0002-5865-5590
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics. Erasmus School of Health Policy & Management, and Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, The Netherlands.ORCID iD: 0000-0003-4822-5068
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Rheumatology.ORCID iD: 0000-0001-5033-0188
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2021 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 104, no 10, p. 2577-2585Article in journal (Refereed) Published
Abstract [en]

Objectives

There is an increased interest in patient preferences informing the development and authorisation of medical products. A requirement for robust and meaningful results of such studies is that patients adequately understand the risks and benefits associated with treatments for which their preferences are elicited. This study aims to determine the influence of an educational tool, compared with traditional written information on patient preferences elicited in a discrete choice experiment (DCE).

Methods

Treatment preferences of Swedish patients with rheumatoid arthritis (RA) were assessed using a DCE. Patients were recruited via clinics, a research panel, and the Swedish Rheumatism Association. Respondents received training materials either as plain written text or as an online educational tool. The educational tool was designed to enhance understanding of the written text by using graphics, pictograms, icon arrays, spoken text, and click-on functions. Data were analysed using random parameter logit models.

Results

675 patients with RA were included in the analysis. The patients received either a written information (n = 358) or information via an educational tool (n = 317). Respondents receiving the educational tool placed relatively more importance on all included side effects in their decision making, compared to respondents receiving the written text, who placed greater importance on treatment effectiveness and administration methods.

Conclusion

Compared to the respondents receiving the written text, the decisions of respondents receiving the educational tool were more influenced by medication side effects. Further research is needed to provide guidance on how and when to use educational tools to inform and elicit patients’ preferences.

Practice implications

The ways in which attributes are presented to patients significantly impacts preferences measured in a DCE.

Place, publisher, year, edition, pages
Elsevier BV Elsevier, 2021. Vol. 104, no 10, p. 2577-2585
Keywords [en]
Digital educational tools, Discrete choice experiments, Medical product lifecycle, Regulatory decisions, Rheumatoid arthritis
National Category
Social and Clinical Pharmacy
Identifiers
URN: urn:nbn:se:uu:diva-438319DOI: 10.1016/j.pec.2021.03.013ISI: 000704999800028PubMedID: 33757643OAI: oai:DiVA.org:uu-438319DiVA, id: diva2:1538849
Projects
IMI-PREFERAvailable from: 2021-03-22 Created: 2021-03-22 Last updated: 2024-01-15Bibliographically approved
In thesis
1. Getting a Say: Bringing patients’ views on benefit-risk into medical approvals
Open this publication in new window or tab >>Getting a Say: Bringing patients’ views on benefit-risk into medical approvals
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The focus of this thesis is a new quantitative approach to consider patient preferences on benefits and risks in medical approvals. The overall aim of this thesis was to explore how patient preference information may be relevant to regulatory marketing authorisation decisions.

Study I provides an overview of the different decision-processes of industry, regulatory agencies and health technology assessment bodies/reimbursement agencies along the medical product lifecycle. In total, 15 decision points with the potential to include patient preference information were identified. 

Study II was an exploration of the patient perspective regarding the use of patient preference information in regulatory marketing authorisation decisions. Patients emphasised the need to have a say in decisions affecting their health and to be properly informed about potential risks and benefits of medical products. 

Study III assessed patient preferences on benefits and risks of Rheumatoid Arthritis treatments. Results revealed that patients’ preferences differed substantially. The three most important treatment attributes for patients with rheumatoid arthritis were: the probability of severe side effects, treatment effectiveness and route of administration. Those placing relatively more importance on treatment effectiveness were willing to acceptance higher risk levels of side effects. 

Study IV aimed to determine the influence of an educational tool, compared with traditional written information on patient preferences. It was found that those respondents receiving the educational tool focused more on the potential side effects than those receiving written information. 

Patient preference information has the potential to reveal patients’ preferences on benefits and risks with scientific rigour and can therefore be weighed against clinical data. This thesis supports the development of a structured approach to learn about patient preferences on benefits and risks in medical approvals

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2021. p. 72
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1732
Keywords
Educational material, Medical product lifecycle, Patient preferences, Regulatory marketing authorisations, Rheumatoid arthritis
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-437909 (URN)978-91-513-1168-5 (ISBN)
Public defence
2021-05-12, Sal X, Universitetshuset, Biskopsgatan 3, Uppsala, 13:00 (English)
Opponent
Supervisors
Available from: 2021-04-21 Created: 2021-03-18 Last updated: 2021-11-05

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Schölin Bywall, KarinVeldwijk, JorienHansson, Mats G.Baecklund, EvaKihlbom, Ulrik

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