Using discrete choice experiments to elicit palliative care preferences in lower middle-income countries: An exploratory study in Bhutan

Background: Design and delivery of specific palliative care in many lower middle-income countries such as Bhutan remains limited. Designing care programmes to respond to the needs of patients and family networks is essential, but evidence on these preferences is limited. Aim: We have conducted a dis...

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Main Authors: Tara Devi Laabar, Richard Norman, Christobel Saunders, Mahbub Ul Alam, Ian W. Li
Format: Article
Language:English
Published: SAGE Publishing 2025-04-01
Series:Palliative Care and Social Practice
Online Access:https://doi.org/10.1177/26323524251334183
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author Tara Devi Laabar
Richard Norman
Christobel Saunders
Mahbub Ul Alam
Ian W. Li
author_facet Tara Devi Laabar
Richard Norman
Christobel Saunders
Mahbub Ul Alam
Ian W. Li
author_sort Tara Devi Laabar
collection DOAJ
description Background: Design and delivery of specific palliative care in many lower middle-income countries such as Bhutan remains limited. Designing care programmes to respond to the needs of patients and family networks is essential, but evidence on these preferences is limited. Aim: We have conducted a discrete choice experiment on Bhutanese patients and family members to explore preferences for palliative care. Design: The discrete choice experiment consisted of 15 choice tasks in which each respondent considered two competing palliative care services. Data were collected through the recruitment of respondents in conjunction with the clinician support teams, with data collected from both patients and their family members. All responses were pooled across the groups and analysed using the conditional logit regression model. Setting/participants: Fifty-seven respondents (20 patients and 37 family members) out of 98 (50 patients and 48 family members) identified (58.2%) were recruited through the three large referral hospitals in Bhutan. Patients had to be diagnosed with an advanced illness or at the end-of-life phase, but be able to understand and be willing to complete the survey. Similarly, family members had to be willing and able to complete the survey, and to be defined as the primary caregiver by the patient. Results: Transparent information provision, cost, family training and use of traditional healing practices were keen drivers of choice, with location of care and place of death relatively less important. Conclusion: Our results will guide future service design decisions in Bhutan and demonstrate the need for localised preference studies to enable culturally appropriate care including the provision of traditional healing practices.
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spelling doaj-art-5654ad410b41417e8a5acbbbc0dc87842025-08-20T02:30:24ZengSAGE PublishingPalliative Care and Social Practice2632-35242025-04-011910.1177/26323524251334183Using discrete choice experiments to elicit palliative care preferences in lower middle-income countries: An exploratory study in BhutanTara Devi Laabar0Richard Norman1Christobel Saunders2Mahbub Ul Alam3Ian W. Li4School of Population and Global Health, University of Western Australia, Perth, WA, AustraliaSchool of Population Health, Curtin University, Perth, WA, AustraliaDepartment of Surgery, Melbourne Medical School, University of Melbourne, Parkville, VIC, AustraliaSchool of Population and Global Health, University of Western Australia, Perth, WA, AustraliaSchool of Management and Marketing, Faculty of Business and Law, Curtin University, Perth, WA, AustraliaBackground: Design and delivery of specific palliative care in many lower middle-income countries such as Bhutan remains limited. Designing care programmes to respond to the needs of patients and family networks is essential, but evidence on these preferences is limited. Aim: We have conducted a discrete choice experiment on Bhutanese patients and family members to explore preferences for palliative care. Design: The discrete choice experiment consisted of 15 choice tasks in which each respondent considered two competing palliative care services. Data were collected through the recruitment of respondents in conjunction with the clinician support teams, with data collected from both patients and their family members. All responses were pooled across the groups and analysed using the conditional logit regression model. Setting/participants: Fifty-seven respondents (20 patients and 37 family members) out of 98 (50 patients and 48 family members) identified (58.2%) were recruited through the three large referral hospitals in Bhutan. Patients had to be diagnosed with an advanced illness or at the end-of-life phase, but be able to understand and be willing to complete the survey. Similarly, family members had to be willing and able to complete the survey, and to be defined as the primary caregiver by the patient. Results: Transparent information provision, cost, family training and use of traditional healing practices were keen drivers of choice, with location of care and place of death relatively less important. Conclusion: Our results will guide future service design decisions in Bhutan and demonstrate the need for localised preference studies to enable culturally appropriate care including the provision of traditional healing practices.https://doi.org/10.1177/26323524251334183
spellingShingle Tara Devi Laabar
Richard Norman
Christobel Saunders
Mahbub Ul Alam
Ian W. Li
Using discrete choice experiments to elicit palliative care preferences in lower middle-income countries: An exploratory study in Bhutan
Palliative Care and Social Practice
title Using discrete choice experiments to elicit palliative care preferences in lower middle-income countries: An exploratory study in Bhutan
title_full Using discrete choice experiments to elicit palliative care preferences in lower middle-income countries: An exploratory study in Bhutan
title_fullStr Using discrete choice experiments to elicit palliative care preferences in lower middle-income countries: An exploratory study in Bhutan
title_full_unstemmed Using discrete choice experiments to elicit palliative care preferences in lower middle-income countries: An exploratory study in Bhutan
title_short Using discrete choice experiments to elicit palliative care preferences in lower middle-income countries: An exploratory study in Bhutan
title_sort using discrete choice experiments to elicit palliative care preferences in lower middle income countries an exploratory study in bhutan
url https://doi.org/10.1177/26323524251334183
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