Renal transplant patients’ preference for the supply and delivery of immunosuppressants in Wales: a discrete choice experiment

BMC Nephrology

Research Article

Anke Hagemi¹  Catrin Plumpton²  Dyfrig A. Hughes² 

[1] Betsi Cadwaladr University Health Board, Ysbyty Gwynedd, Bangor, Wales, UK;Centre for Health Economics and Medicines Evaluation, Bangor University, Ardudwy, Holyhead Road, LL57 2PZ, Bangor, Wales, UK;

关键词: Discrete choice experiment;    Immunosuppressants;    Drug prescribing;    Patient preference;    Kidney transplantation;   

DOI  :  10.1186/s12882-017-0720-5

 received in 2016-11-02, accepted in 2017-09-20,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundPrescribing policy recommendations aimed at moving immunosuppressant prescribing for renal transplant patients from primary to secondary care may result in benefits of increased safety and reduced cost. However, there is little evidence of patients’ preferences for receiving their immunosuppressant therapy from hospitals compared to community dispensing. The aim of this study was to elicit patient preferences for different service configurations focusing in particular on home delivery versus collection of medication from hospital.MethodsA discrete choice experiment was administered to 265 renal transplant patients in North Wales. Respondents were presented 18 pairwise choices, labelled as either home delivery or hospital collection, and described by the attributes: frequency of supply, waiting time (for delivery or collection) and method of ordering (provider contact, patient contact via phone, patient contact electronically). Data were analysed using a random-effects logit model and marginal rates of substitution calculated based on the waiting time attribute.ResultsA response rate of 63% was achieved, with 5332 usable observations from 150 respondents. Method of delivery (β coefficient 1.21; 95% confidence interval 1.05 to 1.38), frequency of supply (0.05; 0.03 to 0.08) waiting time (−0.00, −0.00 to −0.00), provider contact (desirable) (0.20; 0.12 to 0.27), patient contact by telephone (desirable) (0.09; 0.01 to 0.17) and patient contact electronically (undesirable) (−0.292; −0.37 to −0.21) were statistically significant (p < 0.05). Results indicate that patients are willing to increase waiting time by nearly 10 h to have a home delivery service.ConclusionPatients indicate a clear preference for a home delivery service. They prefer providers to make contact when new immunosuppressant supplies are required and show preference against ordering medication electronically. A policy for secondary care prescribing and hospital collection of medicines does not align with this preference.

【 授权许可】

CC BY   
© The Author(s). 2017