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Title:
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Patient Preferences in Surveillance: Findings From a Discrete Choice Experiment in the "My Follow-Up" Study.
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Authors:
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McFerran E; Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, Northern Ireland, UK. Electronic address: .
Boeri M; RTI Health Solutions, Belfast, Northern Ireland, UK.
Kee F; Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, Northern Ireland, UK.
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Source:
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Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research [Value Health] 2020 Oct; Vol. 23 (10), pp. 1373-1383. Date of Electronic Publication: 2020 Aug 21.
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Publication Type:
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Journal Article; Research Support, Non-U.S. Gov't
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Language:
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English
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Imprint Name(s):
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Publication: Jan./Feb. 2011- : New York : Elsevier
Original Publication: Malden, MA : Blackwell Science, c1998-
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MeSH Terms:
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Choice Behavior*
Patient Preference*/psychology
Patient Preference*/statistics & numerical data
Colorectal Neoplasms/*diagnosis
Early Detection of Cancer/*psychology
Colonic Polyps/surgery ; Colonoscopy/psychology ; Early Detection of Cancer/methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Northern Ireland ; Risk Reduction Behavior
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Contributed Indexing:
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Keywords: cancer risk; colorectal cancer; diet; discrete choice experiment; latent class modeling; lifestyle; postpolypectomy; preference elicitation; surveillance
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Entry Date(s):
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Date Created: 20201009 Date Completed: 20210219 Latest Revision: 20210219
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Update Code:
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20240105
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DOI:
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10.1016/j.jval.2020.05.015
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PMID:
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33032782
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Objectives: Approximately 800 000 people die globally from colorectal cancer (CRC) every year. Prevention programs promote early detection, but for people with precancerous lesions, tailoring surveillance to include lifestyle-change programs could enhance prevention potential and improve outcomes.
Methods: Those with intermediate or high-risk polyps removed during CRC screening colonoscopy within the Northern Ireland CRC Screening Programme were invited to complete 8 discrete choice questions about tailored surveillance, analyzed using random-parameters logit and a latent class modeling approach.
Results: A total of 231 participants (77% male) self-reported comorbid hypertension (53%), high cholesterol (48%), and mean body mass index of 28.7 (overweight). Although 39% of participants were unaware of their CRC risk status, 30.9% indicated they were already making changes to reduce their risk. Although all respondents were significantly risk- and cost-averse, the latent class analysis identified 3 segments (classes): 1. Class 1 (26.8%) significantly favored phone or email support for a lifestyle change, a 17-month testing interval, and noninvasive testing. 2. Class 2 (48.4%) preferred the status quo. 3. Class 3 (24.7%) significantly favored further risk reduction and invasive testing.
Conclusions: This is the first documented preference study focusing on postpolypectomy surveillance offering lifestyle interventions. Although current care is strongly preferred, risk and cost aversion are important for participants. Latent class analysis shows that some respondents are willing to change diet and lifestyle behaviors, reflecting a teachable moment, with opportunities to personalize and optimize surveillance. Significant discordance between perceived and known risk of recurrence and limited recall of risk information provided within current practice suggest necessary improvements to surveillance programs.
(Copyright © 2020 ISPOR–The Professional Society for Health Economics and Outcomes Research. Published by Elsevier Inc. All rights reserved.)
