Supportive Care in Cancer

, Volume 21, Issue 1, pp 245–251

Eliciting patients’ preferences for outpatient treatment of febrile neutropenia: a discrete choice experiment

Authors

    • Department of Pharmaceutical SciencesUniversity of Toronto
    • Division of Clinical Pharmacology, Department of MedicineSunnybrook Health Sciences Centre
  • Pierre K. Isogai
    • Health Outcomes and PharmacoEconomics Research Centre, Division of Clinical PharmacologySunnybrook Health Sciences Centre
  • Scott E. Walker
    • Department of Pharmaceutical SciencesUniversity of Toronto
    • Department of PharmacySunnybrook Health Sciences Centre
  • Carlo De Angelis
    • Department of Pharmaceutical SciencesUniversity of Toronto
    • Department of PharmacySunnybrook Health Sciences Centre
  • Matthew C. Cheung
    • Division of Hematology/Oncology, Department of MedicineSunnybrook Health Sciences Centre
  • Jeffrey S. Hoch
    • Department of Pharmaceutical SciencesUniversity of Toronto
    • Department of Health Policy, Management and EvaluationUniversity of Toronto
    • Keenan Research Centre, Li Ka Shing Knowledge InstituteSt. Michael’s Hospital
    • Pharmacoeconomics Research UnitCancer Care Ontario
  • Nicole Mittmann
    • Health Outcomes and PharmacoEconomics Research Centre, Division of Clinical PharmacologySunnybrook Health Sciences Centre
    • Department of PharmacologyUniversity of Toronto
    • International Centre for Health Innovation and Leadership, Richard Ivey School of BusinessUniversity of Western Ontario
Original Article

DOI: 10.1007/s00520-012-1517-5

Cite this article as:
Lathia, N., Isogai, P.K., Walker, S.E. et al. Support Care Cancer (2013) 21: 245. doi:10.1007/s00520-012-1517-5

Abstract

Background

Studies have demonstrated that patients at low risk for febrile neutropenia (FN) complications can be treated safely and effectively at home. Information on patient preferences for outpatient treatment of this condition will help to optimize health care delivery to these patients. The purpose of this study was to elicit non-Hodgkin lymphoma patients’ preferences on attributes related to outpatient treatment of FN.

Methods

We used a self-administered discrete choice experiment questionnaire based on the attributes of out-of-pocket costs, unpaid caregiver time required daily, and probability of return to the hospital. Ten paired scenarios in which levels of the attributes were varied were presented to study patients. For each pair, patients indicated the scenario they preferred. Adjusted odds ratios (ORs) of accepting a scenario that described outpatient care for FN were estimated.

Results

Eighty-eight patients completed the questionnaire. Adjusted ORs [95 % confidence intervals] of accepting outpatient care for FN were 0.84 [0.75, 0.95] for each $10 increase in out-of-pocket cost; 0.82 [0.68, 0.99] for each 1 h increase in daily unpaid caregiver time; and 0.53 [0.50, 0.57] for each 5 % increase in probability of return to the hospital.

Conclusions

Probability of return to the hospital was the most important attribute to patients when considering home-based care for FN. Patients considered out-of-pocket costs and unpaid caregiver time to be less important than probability of return to the hospital. This study identifies factors that could be incorporated into outpatient delivery systems for FN care to ensure adequate patient uptake and satisfaction with such programs.

Keywords

Febrile neutropeniaPreferencesDiscrete choice experimentHealth services research

Supplementary material

520_2012_1517_MOESM1_ESM.pdf (52 kb)
ESM 1(PDF 51 kb)

Copyright information

© Springer-Verlag 2012