Applying best-worst scaling to identify health-outcome preferences among patients with diabetes or hypertension and multiple chronic conditions

ID: 

1041

Session: 

Poster session 1 Wednesday: Evidence production and synthesis

Date: 

Wednesday 13 September 2017 - 12:30 to 14:00

Location: 

Exhibition Halls 1 & 2

All authors in correct order:

Aschmann HE1, Puhan MA1, Armacost K2, Bayliss EA3, Bennett WL4, Chan WV5, Glover C6, Leff B7, Maslow K8, Mintz S9, Mularski RA5, Robbins CW10, Sheehan OC7, Wilson R11, Yu T12, Boyd CM4
1 Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland
2 Patient Caregiver, Informing Patient-Centered Care for People with Multiple Chronic Conditions Patient and Caregiver Partners, USA
3 Kaiser Permanente, Institute for Health Research, Denver, CO, USA
4 The Johns Hopkins University School of Medicine & The Johns Hopkins University School of Public Health, Baltimore, MD, USA
5 Kaiser Permanente National Guideline Program, USA
6 Patient Caregiver, Informing Patient-Centered Care for People with Multiple Chronic Conditions Patient and Caregiver Partners & Sought Out Redeemed Hope Center, USA
7 The Johns Hopkins University School of Medicine, Baltimore, MD, USA
8 Gerontological Society of America, Washington, DC, USA
9 Founder Family Caregiver Advocacy, USA
10 Kaiser Permanente National Guideline Program & Kaiser Permanente, Institute for Health Research, Denver, CO, USA
11 The Johns Hopkins University School of Public Health, Baltimore, MD, USA
12 Department of Public Health, China Medical University (ROC), Taichung, Taiwan
Presenting author and contact person

Presenting author:

Hélène Aschmann

Contact person:

Hélène Aschmann
Abstract text
Background: Treatment decisions and guideline development need to consider patient values and preferences. There is little evidence in the literature on patient preferences for health outcomes in people with hypertension or diabetes and multiple chronic conditions.

Objectives: To elicit patient preferences for clinically relevant and patient-important outcomes to guide decision making for treatment of hypertension and diabetes among people with multiple chronic conditions.

Methods: In collaboration with patient and caregiver focus groups, we determined clinically relevant and patient-important outcomes for two questions, one on second-line treatments for diabetes and the other on blood-pressure targets in hypertension. We designed the surveys as best-worst scaling tasks (case 1) based on the balanced, incomplete-block design. We sent both surveys to Kaiser Permanente Colorado patients with multiple chronic conditions and a Quan score of at least 3 and who have diabetes or hypertension, respectively. The analysis used best minus worst scores (BMWS) based on a preliminary dataset (N=154 (diabetes)/148 (hypertension)). BMWS reflect how many times an outcome was selected as best or worst, averaged across respondents. The range of scores depends on the design, i.e. how many times the outcome can be selected. The range is [-4,4] for diabetes and [-5,5] for hypertension outcomes.

Results: Our response rate was 46 per cent. BMWS are shown in Figure 1 for diabetes, and Figure 2 for hypertension. In diabetes loss of vision was considered the most worrisome outcome, followed by stroke and myocardial infarction. The least worrisome events were nausea or diarrhoea, mild depression and weight gain. In the hypertension survey, stroke was considered the most worrisome health outcome, followed by heart failure and myocardial infarction. The least worrisome were treatment burden, injurious falls and hypotension or dizziness. In both cases, mean scores did not go to the extremes.

Conclusions: The best-worst scaling allowed good discrimination between the importance of health outcomes among people with multiple chronic condititions.

Attachments: 

Image icon preferences_figure1.png
Image icon preferences_figure2.png