A protocol for a discrete choice experiment: understanding patient medicine preferences for managing chronic non-cancer pain

Introduction High rates of chronic non-cancer pain (CNCP), concerns about adverse effects including dependence among those prescribed potent pain medicines, the recent evidence supporting active rather than passive management strategies and a lack of funding for holistic programme have resulted in c...

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Main Authors: Marian Shanahan, Suzanne Nielsen, Briony Larance, Milton Cohen, Maria Schaffer, Gabrielle Campbell
Format: Article
Language:English
Published: BMJ Publishing Group 2019-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/8/e027153.full
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author Marian Shanahan
Suzanne Nielsen
Briony Larance
Milton Cohen
Maria Schaffer
Gabrielle Campbell
author_facet Marian Shanahan
Suzanne Nielsen
Briony Larance
Milton Cohen
Maria Schaffer
Gabrielle Campbell
author_sort Marian Shanahan
collection DOAJ
description Introduction High rates of chronic non-cancer pain (CNCP), concerns about adverse effects including dependence among those prescribed potent pain medicines, the recent evidence supporting active rather than passive management strategies and a lack of funding for holistic programme have resulted in challenges around decision making for treatment among clinicians and their patients. Discrete choice experiments (DCEs) are one way of assessing and valuing treatment preferences. Here, we outline a protocol for a study that assesses patient preferences for CNCP treatment.Methods and analysis A final list of attributes (and their levels) for the DCE was generated using a detailed iterative process. This included a literature review, a focus group and individual interviews with those with CNCP and clinicians who treat people with CNCP. From this process a list of attributes was obtained. Following a review by study investigators including pain and addiction specialists, pharmacists and epidemiologists, the final list of attributes was selected (number of medications, risk of addiction, side effects, pain interference, activity goals, source of information on pain, provider of pain care and out-of-pocket costs). Specialised software was used to construct an experimental design for the survey. The survey will be administered to two groups of participants, those from a longitudinal cohort of patients receiving opioids for CNCP and a convenience sample of patients recruited through Australia’s leading pain advocacy body (Painaustralia) and their social media and website. The data from the two participant groups will be initially analysed separately, as their demographic and clinical characteristics may differ substantially (in terms of age, duration of pain and current treatment modality). Mixed logit and latent class analysis will be used to explore heterogeneity of responses.Ethics and dissemination Ethics approval was obtained from the University of New South Wales Sydney Human Ethics committee HC16511 (for the focus group discussions, the one-on-one interviews and online survey) and HC16916 (for the cohort). A lay summary will be made available on the National Drug and Alcohol Research Centre website and Painaustralia’s website. Peer review papers will be submitted, and it is expected the results will be presented at relevant pain management conferences nationally and internationally. These results will also be used to improve understanding of treatment goals between clinicians and those with CNCP.
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spelling doaj-art-ea0ed1e85c384faa9f0ef9ffbaab81e12024-11-27T02:30:09ZengBMJ Publishing GroupBMJ Open2044-60552019-08-019810.1136/bmjopen-2018-027153A protocol for a discrete choice experiment: understanding patient medicine preferences for managing chronic non-cancer painMarian Shanahan0Suzanne Nielsen1Briony Larance2Milton Cohen3Maria Schaffer4Gabrielle Campbell51 National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, AustraliaNational Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia1 National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia4 Vincent’s Clinical School, UNSW Medicine, University of New South Wales, Sydney, New South Wales, Australia1 National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia16 School of Psychology, University of Queensland, Queensland, Queensland, AustraliaIntroduction High rates of chronic non-cancer pain (CNCP), concerns about adverse effects including dependence among those prescribed potent pain medicines, the recent evidence supporting active rather than passive management strategies and a lack of funding for holistic programme have resulted in challenges around decision making for treatment among clinicians and their patients. Discrete choice experiments (DCEs) are one way of assessing and valuing treatment preferences. Here, we outline a protocol for a study that assesses patient preferences for CNCP treatment.Methods and analysis A final list of attributes (and their levels) for the DCE was generated using a detailed iterative process. This included a literature review, a focus group and individual interviews with those with CNCP and clinicians who treat people with CNCP. From this process a list of attributes was obtained. Following a review by study investigators including pain and addiction specialists, pharmacists and epidemiologists, the final list of attributes was selected (number of medications, risk of addiction, side effects, pain interference, activity goals, source of information on pain, provider of pain care and out-of-pocket costs). Specialised software was used to construct an experimental design for the survey. The survey will be administered to two groups of participants, those from a longitudinal cohort of patients receiving opioids for CNCP and a convenience sample of patients recruited through Australia’s leading pain advocacy body (Painaustralia) and their social media and website. The data from the two participant groups will be initially analysed separately, as their demographic and clinical characteristics may differ substantially (in terms of age, duration of pain and current treatment modality). Mixed logit and latent class analysis will be used to explore heterogeneity of responses.Ethics and dissemination Ethics approval was obtained from the University of New South Wales Sydney Human Ethics committee HC16511 (for the focus group discussions, the one-on-one interviews and online survey) and HC16916 (for the cohort). A lay summary will be made available on the National Drug and Alcohol Research Centre website and Painaustralia’s website. Peer review papers will be submitted, and it is expected the results will be presented at relevant pain management conferences nationally and internationally. These results will also be used to improve understanding of treatment goals between clinicians and those with CNCP.https://bmjopen.bmj.com/content/9/8/e027153.full
spellingShingle Marian Shanahan
Suzanne Nielsen
Briony Larance
Milton Cohen
Maria Schaffer
Gabrielle Campbell
A protocol for a discrete choice experiment: understanding patient medicine preferences for managing chronic non-cancer pain
BMJ Open
title A protocol for a discrete choice experiment: understanding patient medicine preferences for managing chronic non-cancer pain
title_full A protocol for a discrete choice experiment: understanding patient medicine preferences for managing chronic non-cancer pain
title_fullStr A protocol for a discrete choice experiment: understanding patient medicine preferences for managing chronic non-cancer pain
title_full_unstemmed A protocol for a discrete choice experiment: understanding patient medicine preferences for managing chronic non-cancer pain
title_short A protocol for a discrete choice experiment: understanding patient medicine preferences for managing chronic non-cancer pain
title_sort protocol for a discrete choice experiment understanding patient medicine preferences for managing chronic non cancer pain
url https://bmjopen.bmj.com/content/9/8/e027153.full
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