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

BACKGROUND: Prescribing 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 immuno...

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Autores principales: Hagemi, Anke, Plumpton, Catrin, Hughes, Dyfrig A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5625806/
https://www.ncbi.nlm.nih.gov/pubmed/28969602
http://dx.doi.org/10.1186/s12882-017-0720-5
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author Hagemi, Anke
Plumpton, Catrin
Hughes, Dyfrig A.
author_facet Hagemi, Anke
Plumpton, Catrin
Hughes, Dyfrig A.
author_sort Hagemi, Anke
collection PubMed
description BACKGROUND: Prescribing 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. METHODS: A 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. RESULTS: A 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. CONCLUSION: Patients 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12882-017-0720-5) contains supplementary material, which is available to authorized users.
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spelling pubmed-56258062017-10-12 Renal transplant patients’ preference for the supply and delivery of immunosuppressants in Wales: a discrete choice experiment Hagemi, Anke Plumpton, Catrin Hughes, Dyfrig A. BMC Nephrol Research Article BACKGROUND: Prescribing 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. METHODS: A 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. RESULTS: A 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. CONCLUSION: Patients 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12882-017-0720-5) contains supplementary material, which is available to authorized users. BioMed Central 2017-10-02 /pmc/articles/PMC5625806/ /pubmed/28969602 http://dx.doi.org/10.1186/s12882-017-0720-5 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Hagemi, Anke
Plumpton, Catrin
Hughes, Dyfrig A.
Renal transplant patients’ preference for the supply and delivery of immunosuppressants in Wales: a discrete choice experiment
title Renal transplant patients’ preference for the supply and delivery of immunosuppressants in Wales: a discrete choice experiment
title_full Renal transplant patients’ preference for the supply and delivery of immunosuppressants in Wales: a discrete choice experiment
title_fullStr Renal transplant patients’ preference for the supply and delivery of immunosuppressants in Wales: a discrete choice experiment
title_full_unstemmed Renal transplant patients’ preference for the supply and delivery of immunosuppressants in Wales: a discrete choice experiment
title_short Renal transplant patients’ preference for the supply and delivery of immunosuppressants in Wales: a discrete choice experiment
title_sort renal transplant patients’ preference for the supply and delivery of immunosuppressants in wales: a discrete choice experiment
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5625806/
https://www.ncbi.nlm.nih.gov/pubmed/28969602
http://dx.doi.org/10.1186/s12882-017-0720-5
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