Eliciting Older Cancer Patients' Preferences for Follow-Up Care to Inform a Primary Healthcare Follow-Up Model in China: A Discrete Choice Experiment.

IF 3.4 3区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Patient-Patient Centered Outcomes Research Pub Date : 2024-09-01 Epub Date: 2024-05-03 DOI:10.1007/s40271-024-00697-4

Jiawei Geng, Ran Li, Xinyu Wang, Rongfang Xu, Jibin Liu, Haiyan Jiang, Gaoren Wang, Therese Hesketh

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Abstract

Background and objectives: Increasing longevity and advances in treatment have increased the cancer burden in the elderly, resulting in complex follow-up care needs; however, in China, little is known about the follow-up care preferences of these patients. This study quantified older cancer patients' preferences for follow-up care and examined the trade-offs they are willing to make to accept an alternative follow-up model.

Methods: A discrete choice experiment was conducted among inpatients aged over 60 years with breast, prostate, or colorectal cancer, at two large tertiary hospitals in Nantong, China. Preference weights for follow-up care were estimated using mixed logit analysis. Subgroup analysis and latent class analysis were used to explore preference heterogeneity.

Results: Complete results were obtained from 422 patients (144 with breast cancer, 133 with prostate cancer, 145 with colorectal cancer), with a mean age of 70.81 years. Older cancer patients stated a preference for follow-up by specialists over primary healthcare (PHC) providers ( $β$ = -1.18, 95% confidence interval -1.40 to -0.97). The provider of follow-up care services was the most valued attribute among patients with breast cancer (relative importance [RI] 37.17%), while remote contact services were prioritized by patients with prostate (RI 43.50%) and colorectal cancer (RI 33.01%). The uptake rate of an alternative care model integrating PHC increased compared with the baseline setting when patients were provided with preferred services (continuity of care, individualized care plans, and remote contact services).

Conclusion: To encourage older cancer patients to use PHC-integrated follow-up care, alternative follow-up care models need to be based on patients' preferences before introducing them as a routine option.

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激发老年癌症患者对随访护理的偏好，为中国基层医疗随访模式提供参考：离散选择实验。

背景和目的：寿命的延长和治疗方法的进步增加了老年人的癌症负担，导致了复杂的随访护理需求；然而，在中国，人们对这些患者的随访护理偏好知之甚少。本研究量化了老年癌症患者对随访护理的偏好，并考察了他们为接受另一种随访模式而愿意做出的权衡：方法：在中国南通的两家大型三甲医院，对 60 岁以上的乳腺癌、前列腺癌或结直肠癌住院患者进行了离散选择实验。实验采用混合 Logit 分析法估算了随访护理的偏好权重。亚组分析和潜类分析用于探讨偏好异质性：从 422 名患者（144 名乳腺癌患者、133 名前列腺癌患者、145 名结直肠癌患者）中获得了完整的结果，这些患者的平均年龄为 70.81 岁。老年癌症患者表示更愿意接受专科医生的随访，而不是初级医疗保健（PHC）提供者（β=-1.18，95% 置信区间-1.40 至-0.97）。乳腺癌患者最看重后续护理服务提供者（相对重要性 [RI] 37.17%），而前列腺癌（RI 43.50%）和结直肠癌（RI 33.01%）患者则优先考虑远程联系服务。在为患者提供首选服务（持续护理、个性化护理计划和远程联系服务）的情况下，与基线设置相比，整合了初级保健的替代护理模式的接受率有所提高：结论：为鼓励老年癌症患者使用整合了初级保健服务的随访护理，在将替代性随访护理模式作为常规选择引入之前，需要根据患者的偏好进行选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Patient-Patient Centered Outcomes Research HEALTH CARE SCIENCES & SERVICES-

CiteScore

6.60

自引率

8.30%

发文量

审稿时长

>12 weeks

期刊介绍： The Patient provides a venue for scientifically rigorous, timely, and relevant research to promote the development, evaluation and implementation of therapies, technologies, and innovations that will enhance the patient experience. It is an international forum for research that advances and/or applies qualitative or quantitative methods to promote the generation, synthesis, or interpretation of evidence. The journal has specific interest in receiving original research, reviews and commentaries related to qualitative and mixed methods research, stated-preference methods, patient reported outcomes, and shared decision making. Advances in regulatory science, patient-focused drug development, patient-centered benefit-risk and health technology assessment will also be considered. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in The Patient may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances. All manuscripts are subject to peer review by international experts.