What do patients and dermatologists prefer regarding low-risk basal cell carcinoma follow-up care? A discrete choice experiment.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2021
2021
Historique:
received:
05
09
2020
accepted:
15
03
2021
entrez:
29
3
2021
pubmed:
30
3
2021
medline:
14
10
2021
Statut:
epublish
Résumé
Follow-up after low-risk basal cell carcinoma (BCC) is being provided more frequently than recommended by guidelines. To design an acceptable strategy to successfully reduce this 'low-value' care, it is important to obtain insights into the preferences of patients and dermatologists. To determine the preferences and needs of patients and dermatologists to reduce low-risk BCC follow-up care, and the trade-offs they are willing to make. A questionnaire including a discrete choice experiment was created, containing attributes regarding amount of follow-up, continuity of care, method of providing addition information, type of healthcare provider, duration of follow-up visits and skin examination. In total, 371 BCC patients and all Dutch dermatologists and dermatology residents (n = 620) were invited to complete the questionnaire. A panel latent class model was used for analysis. Eighty-four dermatologists and 266 BCC patients (21% and 72% response rates respectively) completed the discrete choice experiment. If the post-treatment visit was performed by the same person as treatment provider and a hand-out was provided to patients containing personalised information, the acceptance of having no additional follow-up visits (i.e. following the guidelines) would increase from 55% to 77% by patients. Female patients and older dermatologists, however, are less willing to accept the guidelines and prefer additional follow-up visits. The low response rate of dermatologists. This discrete choice experiment revealed a feasible strategy to substantially reduce costs, while maintaining quality of care, based on the preferences and needs of BCC patients, which is supported by dermatologists.
Sections du résumé
BACKGROUND
Follow-up after low-risk basal cell carcinoma (BCC) is being provided more frequently than recommended by guidelines. To design an acceptable strategy to successfully reduce this 'low-value' care, it is important to obtain insights into the preferences of patients and dermatologists.
OBJECTIVE
To determine the preferences and needs of patients and dermatologists to reduce low-risk BCC follow-up care, and the trade-offs they are willing to make.
METHODS
A questionnaire including a discrete choice experiment was created, containing attributes regarding amount of follow-up, continuity of care, method of providing addition information, type of healthcare provider, duration of follow-up visits and skin examination. In total, 371 BCC patients and all Dutch dermatologists and dermatology residents (n = 620) were invited to complete the questionnaire. A panel latent class model was used for analysis.
RESULTS
Eighty-four dermatologists and 266 BCC patients (21% and 72% response rates respectively) completed the discrete choice experiment. If the post-treatment visit was performed by the same person as treatment provider and a hand-out was provided to patients containing personalised information, the acceptance of having no additional follow-up visits (i.e. following the guidelines) would increase from 55% to 77% by patients. Female patients and older dermatologists, however, are less willing to accept the guidelines and prefer additional follow-up visits.
LIMITATIONS
The low response rate of dermatologists.
CONCLUSION
This discrete choice experiment revealed a feasible strategy to substantially reduce costs, while maintaining quality of care, based on the preferences and needs of BCC patients, which is supported by dermatologists.
Identifiants
pubmed: 33780499
doi: 10.1371/journal.pone.0249298
pii: PONE-D-20-27986
pmc: PMC8007023
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0249298Déclaration de conflit d'intérêts
We understand that VGZ must be explicitly mentioned as a commercial funder. We would like to alter our Competing Interest Statement to: “The authors and funders (Dutch Ministry of Health, Welfare and Sport and the health insurance company VGZ) have declared that no competing interests exist. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
Références
Pharmacoeconomics. 2014 Sep;32(9):883-902
pubmed: 25005924
Pharmacoeconomics. 2019 Feb;37(2):201-226
pubmed: 30392040
Support Care Cancer. 2010 Feb;18(2):225-33
pubmed: 19430819
Br J Dermatol. 2019 Jan;180(1):122-129
pubmed: 29927480
Pharmacoeconomics. 2010;28(6):507-20
pubmed: 20387912
Br J Dermatol. 2011 Oct;165(4):874-81
pubmed: 21711333
Eur J Cancer. 2019 Aug;117:32-40
pubmed: 31229947
Health Econ. 2017 Jun;26(6):810-817
pubmed: 27122445
Patient. 2015 Oct;8(5):373-84
pubmed: 25726010
Br J Cancer. 2004 Mar 22;90(6):1144-50
pubmed: 15026793
Health Serv Res. 2001 Feb;35(6):1347-55
pubmed: 11221823
Yale J Biol Med. 2015 Jun 01;88(2):167-79
pubmed: 26029015
Health Econ. 2005 Oct;14(10):1079-83
pubmed: 15852455
Eur J Cancer Prev. 2015 Mar;24(2):141-9
pubmed: 25089375
Acta Oncol. 2010 Apr;49(3):328-37
pubmed: 20148645
Br J Cancer. 2010 May 11;102(10):1447-55
pubmed: 20461089
Br J Dermatol. 2019 Jun;180(6):1420-1429
pubmed: 30597525
Eur J Surg Oncol. 2014 Dec;40(12):1655-61
pubmed: 25108811
Breast. 2008 Aug;17(4):347-52
pubmed: 18455404
MedGenMed. 2001 Mar 05;3(2):2
pubmed: 11549951
Health Serv Res. 2005 Feb;40(1):213-26
pubmed: 15663710
Med Care. 2016 Jan;54(1):45-54
pubmed: 26595223
Value Health. 2013 Jan-Feb;16(1):3-13
pubmed: 23337210
BMC Med Res Methodol. 2015 Apr 09;15:32
pubmed: 25888346
Dtsch Arztebl Int. 2014 Aug 4;111(31-32):537-44
pubmed: 25145512
Eur J Dermatol. 2014 May-Jun;24(3):312-29
pubmed: 24723647
Br J Dermatol. 2017 Aug;177(2):359-372
pubmed: 28220485
BMJ. 1999 Nov 6;319(7219):1241-7
pubmed: 10550090
J Fam Pract. 2004 Dec;53(12):974-80
pubmed: 15581440