Using a DCE to value support in self-management of chronic pain

A discrete choice experiment to value the personalisation of support for the self-management of chronic pain

The context was the support people receive for self-management, firstly for chronic pain, then in a replication study, for chronic lung disease. The DCE included four attributes: information (‘relevant to you’ vs. ‘the same for everyone’); communication style (‘friendly and personal’ vs. ‘neutral professional’); situation relevance (‘makes suggestions which fit your situation’ vs. ‘takes little account of your situation’); and what matters in life (‘works with you on what you want to get from life’ vs. ‘seems to think everyone wants to get the same from life’). A cost attribute was included so that willingness to pay (WTP) could be estimated.

We recruited participants from an online panel: 517 with self-reported chronic pain and 200 with breathlessness. Participants revealed positive valuations for increased personalisation of all four attributes. Greater personalisation on the attributes relating to situation relevance (WTP £15.51) and what matters in life (WTP £14.10) were valued most highly; tailored information was valued less (WTP £10.86) and more friendly communication valued least (WTP £3.46). The replication study in breathlessness showed similar results. We also found heterogeneity in valuation, particularly around the relative value of tailored information.

Outcome and Translation 

Our results should lead healthcare providers to rethink how we make support for self-management properly person-centred. Person-centred healthcare must emphasise the substance of personalisation and not just the style.

HERU researchers involved in this research project: Mandy Ryan and Nicolas Krucien.

External collaborators: C Burton, T Porteous, A Elliott (Centre of Academic Primary Care, University of Aberdeen) and V Entwistle (HSRU, University of Aberdeen)

This project is funded by The Health Foundation Inspiring Improvement programme.

Publications

Burton, C.D., Entwistle, V.A., Elliott, A.M., Krucien, N., Porteous, T. and Ryan, M. (2017) 'The value of different aspects of person-centred care: a series of discrete choice experiments in people with long-term conditions', BMJ Open, 7(4).

Presentations

Burton, C., Entwistle, V., Krucien, N., Elliott, A., Porteous, T. and Ryan, M. (2016) 'Substance or style? Valuing aspects of personalisation of the support for self-management', Society of Academic Primary Care Annual Scientific Meeting, Dublin, Ireland, 6-8 July 2016.

Krucien, N. (2016) 'Does it matter to analyse preferences at the individual level? Evidence from a choice experiment about chronic pain self-management.', European Health Economics Association Conference, 'Know the Ropes - Balancing Costs and Quality in Health Care', Universität Hamburg, Germany 13-16 July 2016.

Krucien, N., Burton, C., Elliott, A., Entwistle, V., Porteous, T. and Ryan, M. (2016) 'I postpone decision making whenever possible. Accounting for decision making styles in individuals' choices for healthcare programmes', Nordic Health Economists' Study Group Meeting, Centre of Health Economics Research (COHERE), University of Southern Denmark, Odense, Denmark, 17-19 August 2016.