Preferences for Palliative and End-of-Life Care: A Systematic Review of Discrete Choice Experiments.

Xia, Q; Kularatna, M; Virdun, C; Button, E; Close, E; Carter, HE

Preferences for Palliative and End-of-Life Care: A Systematic Review of Discrete Choice Experiments.

Xia, Q Kularatna, M Virdun, C

Button, E Close, E Carter, HE

Permalink

Publisher:: Elsevier
Publication Type:: Journal Article
Citation:: Value Health, 2023, pp. S1098-3015(23)03071-1
Issue Date:: 2023-08-03

Open Access

Copyright Clearance Process

Recently Added
In Progress
Open Access

This item is open access.

Adobe PDF

Download Published versionAdobe PDF (1.37 MB)

View on publisher's site

View statistics

Full metadata record

Field	Value	Language
dc.contributor.author	Xia, Q
dc.contributor.author	Kularatna, M
dc.contributor.author	Virdun, C https://orcid.org/0000-0003-3945-0749
dc.contributor.author	Button, E
dc.contributor.author	Close, E
dc.contributor.author	Carter, HE
dc.date.accessioned	2023-11-03T03:42:48Z
dc.date.available	2023-07-22
dc.date.available	2023-11-03T03:42:48Z
dc.date.issued	2023-08-03
dc.identifier.citation	Value Health, 2023, pp. S1098-3015(23)03071-1
dc.identifier.issn	1098-3015
dc.identifier.issn	1524-4733
dc.identifier.uri	http://hdl.handle.net/10453/172968
dc.description.abstract	OBJECTIVES: Understanding what matters most to patients and their caregivers is fundamental to delivering high-quality care. This systematic review aimed to characterize and appraise the evidence from discrete choice experiments eliciting preferences for palliative care. METHODS: A systematic literature search was undertaken for publications up until August 2022. Data were synthesized narratively. Thematic analysis was applied to categorize attributes into groups. Attribute development, frequency, and relative importance were analyzed. Subgroup analyses were conducted to compare outcomes between patient and proxy respondents. RESULTS: Seventeen studies spanning 11 countries were included; 59% of studies solely considered preferences for patients with cancer. A range of respondent groups were represented including patients (76%) and proxies (caregivers [35%], health providers [12%], and the public [18%]). A total of 117 individual attributes were extracted and thematically grouped into 8 broad categories and 21 subcategories. Clinical outcomes including quality of life, length of life, and pain control were the most frequently reported attributes, whereas attributes relating to psychosocial components were largely absent. Both patients and proxy respondents prioritized pain control over additional survival time. Nevertheless, there were differences between respondent cohorts in the emphasis on other attributes such as access to care, timely information, and low risk of adverse effects (prioritized by patients), as opposed to cost, quality, and delivery of care (prioritized by proxies). CONCLUSIONS: Our review underscores the vital role of pain control in palliative care; in addition, it shed light on the complexity and relative strength of preferences for various aspects of care from multiple perspectives, which is useful in developing personalized, patient-centered models of care for individuals nearing the end of life.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Elsevier
dc.relation.ispartof	Value Health
dc.relation.isbasedon	10.1016/j.jval.2023.07.005
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1117 Public Health and Health Services, 1402 Applied Economics
dc.subject.classification	Health Policy & Services
dc.subject.classification	3801 Applied economics
dc.subject.classification	4203 Health services and systems
dc.subject.classification	4407 Policy and administration
dc.title	Preferences for Palliative and End-of-Life Care: A Systematic Review of Discrete Choice Experiments.
dc.type	Journal Article
utslib.location.activity	United States
utslib.for	1117 Public Health and Health Services
utslib.for	1402 Applied Economics
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	open_access	*
dc.date.updated	2023-11-03T03:42:47Z
pubs.publication-status	Published online

Abstract:

OBJECTIVES: Understanding what matters most to patients and their caregivers is fundamental to delivering high-quality care. This systematic review aimed to characterize and appraise the evidence from discrete choice experiments eliciting preferences for palliative care. METHODS: A systematic literature search was undertaken for publications up until August 2022. Data were synthesized narratively. Thematic analysis was applied to categorize attributes into groups. Attribute development, frequency, and relative importance were analyzed. Subgroup analyses were conducted to compare outcomes between patient and proxy respondents. RESULTS: Seventeen studies spanning 11 countries were included; 59% of studies solely considered preferences for patients with cancer. A range of respondent groups were represented including patients (76%) and proxies (caregivers [35%], health providers [12%], and the public [18%]). A total of 117 individual attributes were extracted and thematically grouped into 8 broad categories and 21 subcategories. Clinical outcomes including quality of life, length of life, and pain control were the most frequently reported attributes, whereas attributes relating to psychosocial components were largely absent. Both patients and proxy respondents prioritized pain control over additional survival time. Nevertheless, there were differences between respondent cohorts in the emphasis on other attributes such as access to care, timely information, and low risk of adverse effects (prioritized by patients), as opposed to cost, quality, and delivery of care (prioritized by proxies). CONCLUSIONS: Our review underscores the vital role of pain control in palliative care; in addition, it shed light on the complexity and relative strength of preferences for various aspects of care from multiple perspectives, which is useful in developing personalized, patient-centered models of care for individuals nearing the end of life.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/172968