Patient preferences for ocular hypertension monitoring: a discrete choice experiment.

BACKGROUND/AIMS

To elicit the preferences and calculate the willingness to pay (WTP) of patients with ocular hypertension (OHT) for eye monitoring services in the UK.

METHODS

Patients with OHT aged at least 18 years recruited from four NHS ophthalmology departments were included in the study. Patients' preferences and WTP for an OHT monitoring service in the National Health Service were elicited using a discrete choice experiment (DCE) within a postal survey based on six attributes: (1) how OHT monitoring is organised, (2) monitoring frequency, (3) travel time from home, (4) use of a risk calculator for conversion to glaucoma, (5) risk of developing glaucoma in the next 10 years and (6) cost of monitoring. We used a sequential mixed-methods approach to design the survey.

RESULTS

360 patients diagnosed with OHT were recruited with a mean age of 69 years. In the DCE, reducing the risk of conversion to glaucoma was the most important factor influencing respondents' choice of monitoring service. Respondents preferred hospital-based monitoring services to community optometrist monitoring, and annual monitoring compared with more frequent (every 6 months) and less frequent (every 18 or 24 months) monitoring. These results can be monetised using WTP. Results of heterogeneity analysis suggest that patients with prior experience in community optometrist monitoring preferred this to hospital-based monitoring.

CONCLUSIONS

Although hospital-based monitoring is generally preferred, patients with prior experience in community services have a different opinion, suggesting that patients who are unfamiliar with community optometry services may need additional support to accept monitoring in this setting.

Informations de copyright

© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: GG: Consulting: Alcon, Allergan, Belkin, Elios, Equinox, Genentech/Roche, Glaukos, Ivantis, McKinsey, Rayner, Reichert, Ripple Therapeutics, Santen, Sight Sciences, Thea, Vialase, Visufarma, Zeiss; Grants: Thea, Santen; Honoraria: Alcon, Allergan, Belkin, Glaukos, Ivantis, Lumibird, McKinsey, Reichert, Sight Sciences, Thea; Travel: Ivantis, Thea; Board membership: Glaucoma UK, UK & Ireland Glaucoma Society. AK: Advisory Board: Thea & Abbvie. DPC: Consulting: Apellis; Financial Support: Apellis, Santen; Recipient: Allergan/Abbvie, Janssen, Santen, Thea. YT: Grants: National Institute of Health Research. VW: Chief Scientist Office, Scotland; National Institute for Health Research; Economic and Social Research Council; Economic and Social Research Council and Global Challenges Research Fund; Imperial College London; The Urology Foundation. RH: Grants: Chief Scientist Office, Scotland; National Institute of Health Research.