Application of a discrete choice experiment approach to support the design of a hepatitis C testing service in primary care

Andrew Radley, Marjon van der Pol, John F Dillon

Research output: Contribution to journalArticle

Abstract

Background Ascertaining the acceptability of healthcare provision to service users is an important factor in promoting service uptake, especially for populations who are reluctant to access care. This study identified the attributes of a Hepatitis C (HCV) testing service for people prescribed Opioid Substitution Therapy (OST) and used their expressed preferences to guide design of a service, using an applied health economics approach. Materials and methods Preferences of OST users were elicited using a discrete choice experiment. Important attributes for HCV testing were partly pre-determined by the research question and also identified using literature review and focus groups. Predetermined attributes included choice of provider and financial incentives. Other important attributes were place of testing; travel distance; attitudes and staff undertaking testing; waiting time for test results and incentive payment. The relative importance of defined attributes was assessed in 103 OST users attending 6 pharmacies from Dundee. Results OST users preferred testing at their “own pharmacy”, by their drug worker, followed by their general practitioner (GP). Use of another pharmacy was the least preferred option. Being treated with dignity and respect was valued most highly, with waiting time for test results and travel distance also important. Financial incentives were not considered important. Conclusions This study provides evidence that OST users prefer testing at their own pharmacy. The addition of a pharmacy to the providers offering HCV testing may increase uptake and support policies to eliminate HCV from our communities. Being treated with dignity and respect was highly valued and this suggests that testing uptake can be increased by developing positive relationships between OST users and test providers. Financial incentives were not found to be important.
Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalInternational Journal of Drug Policy
Volume65
Early online date18 Dec 2018
DOIs
Publication statusPublished - Mar 2019

Fingerprint

Opiate Substitution Treatment
Hepatitis C
Primary Health Care
Motivation
Patient Acceptance of Health Care
Attitude of Health Personnel
Pharmacies
Focus Groups
General Practitioners
Economics
Health
Research

Keywords

  • Hepatitis C
  • Clinical pathways
  • Community pharmacy
  • Discrete choice experiment

Cite this

@article{86d953ce239a4d7db380c007245f422f,
title = "Application of a discrete choice experiment approach to support the design of a hepatitis C testing service in primary care",
abstract = "Background Ascertaining the acceptability of healthcare provision to service users is an important factor in promoting service uptake, especially for populations who are reluctant to access care. This study identified the attributes of a Hepatitis C (HCV) testing service for people prescribed Opioid Substitution Therapy (OST) and used their expressed preferences to guide design of a service, using an applied health economics approach. Materials and methods Preferences of OST users were elicited using a discrete choice experiment. Important attributes for HCV testing were partly pre-determined by the research question and also identified using literature review and focus groups. Predetermined attributes included choice of provider and financial incentives. Other important attributes were place of testing; travel distance; attitudes and staff undertaking testing; waiting time for test results and incentive payment. The relative importance of defined attributes was assessed in 103 OST users attending 6 pharmacies from Dundee. Results OST users preferred testing at their “own pharmacy”, by their drug worker, followed by their general practitioner (GP). Use of another pharmacy was the least preferred option. Being treated with dignity and respect was valued most highly, with waiting time for test results and travel distance also important. Financial incentives were not considered important. Conclusions This study provides evidence that OST users prefer testing at their own pharmacy. The addition of a pharmacy to the providers offering HCV testing may increase uptake and support policies to eliminate HCV from our communities. Being treated with dignity and respect was highly valued and this suggests that testing uptake can be increased by developing positive relationships between OST users and test providers. Financial incentives were not found to be important.",
keywords = "Hepatitis C, Clinical pathways, Community pharmacy, Discrete choice experiment",
author = "Andrew Radley and {van der Pol}, Marjon and Dillon, {John F}",
note = "Declarations Study documents were submitted to the East of Scotland Research Ethics Service, who confirmed this work did not require Ethical Approval. Caldecott permission was gained to enable access to and analysis of patient information. All relevant data are within the paper and its supporting information files. Reporting Guideline: ISPOR Task Force Report - Constructing experimental designs for discrete-choice experiments: report of the ISPOR conjoint analysis experimental design good research practices task force. Value in Health 16 (2013) 3–13. Funding This study was supported in part through a grant from Gilead Sciences Ltd. HERU is funded by the Chief Scientist Office (CSO), Scottish Government Health Directorates, St Andrew’s House, Edinburgh. The views expressed in this paper are those of the authors only and not those of the CSO. The funders had no role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.",
year = "2019",
month = "3",
doi = "10.1016/j.drugpo.2018.12.008",
language = "English",
volume = "65",
pages = "1--7",
journal = "International Journal of Drug Policy",
issn = "0955-3959",
publisher = "Elsevier",

}

TY - JOUR

T1 - Application of a discrete choice experiment approach to support the design of a hepatitis C testing service in primary care

AU - Radley, Andrew

AU - van der Pol, Marjon

AU - Dillon, John F

N1 - Declarations Study documents were submitted to the East of Scotland Research Ethics Service, who confirmed this work did not require Ethical Approval. Caldecott permission was gained to enable access to and analysis of patient information. All relevant data are within the paper and its supporting information files. Reporting Guideline: ISPOR Task Force Report - Constructing experimental designs for discrete-choice experiments: report of the ISPOR conjoint analysis experimental design good research practices task force. Value in Health 16 (2013) 3–13. Funding This study was supported in part through a grant from Gilead Sciences Ltd. HERU is funded by the Chief Scientist Office (CSO), Scottish Government Health Directorates, St Andrew’s House, Edinburgh. The views expressed in this paper are those of the authors only and not those of the CSO. The funders had no role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.

PY - 2019/3

Y1 - 2019/3

N2 - Background Ascertaining the acceptability of healthcare provision to service users is an important factor in promoting service uptake, especially for populations who are reluctant to access care. This study identified the attributes of a Hepatitis C (HCV) testing service for people prescribed Opioid Substitution Therapy (OST) and used their expressed preferences to guide design of a service, using an applied health economics approach. Materials and methods Preferences of OST users were elicited using a discrete choice experiment. Important attributes for HCV testing were partly pre-determined by the research question and also identified using literature review and focus groups. Predetermined attributes included choice of provider and financial incentives. Other important attributes were place of testing; travel distance; attitudes and staff undertaking testing; waiting time for test results and incentive payment. The relative importance of defined attributes was assessed in 103 OST users attending 6 pharmacies from Dundee. Results OST users preferred testing at their “own pharmacy”, by their drug worker, followed by their general practitioner (GP). Use of another pharmacy was the least preferred option. Being treated with dignity and respect was valued most highly, with waiting time for test results and travel distance also important. Financial incentives were not considered important. Conclusions This study provides evidence that OST users prefer testing at their own pharmacy. The addition of a pharmacy to the providers offering HCV testing may increase uptake and support policies to eliminate HCV from our communities. Being treated with dignity and respect was highly valued and this suggests that testing uptake can be increased by developing positive relationships between OST users and test providers. Financial incentives were not found to be important.

AB - Background Ascertaining the acceptability of healthcare provision to service users is an important factor in promoting service uptake, especially for populations who are reluctant to access care. This study identified the attributes of a Hepatitis C (HCV) testing service for people prescribed Opioid Substitution Therapy (OST) and used their expressed preferences to guide design of a service, using an applied health economics approach. Materials and methods Preferences of OST users were elicited using a discrete choice experiment. Important attributes for HCV testing were partly pre-determined by the research question and also identified using literature review and focus groups. Predetermined attributes included choice of provider and financial incentives. Other important attributes were place of testing; travel distance; attitudes and staff undertaking testing; waiting time for test results and incentive payment. The relative importance of defined attributes was assessed in 103 OST users attending 6 pharmacies from Dundee. Results OST users preferred testing at their “own pharmacy”, by their drug worker, followed by their general practitioner (GP). Use of another pharmacy was the least preferred option. Being treated with dignity and respect was valued most highly, with waiting time for test results and travel distance also important. Financial incentives were not considered important. Conclusions This study provides evidence that OST users prefer testing at their own pharmacy. The addition of a pharmacy to the providers offering HCV testing may increase uptake and support policies to eliminate HCV from our communities. Being treated with dignity and respect was highly valued and this suggests that testing uptake can be increased by developing positive relationships between OST users and test providers. Financial incentives were not found to be important.

KW - Hepatitis C

KW - Clinical pathways

KW - Community pharmacy

KW - Discrete choice experiment

U2 - 10.1016/j.drugpo.2018.12.008

DO - 10.1016/j.drugpo.2018.12.008

M3 - Article

VL - 65

SP - 1

EP - 7

JO - International Journal of Drug Policy

JF - International Journal of Drug Policy

SN - 0955-3959

ER -