Format

Send to

Choose Destination
Br J Gen Pract. 2019 Aug 29;69(686):e629-e637. doi: 10.3399/bjgp19X705101. Print 2019 Sep.

Patient preferences for management of high blood pressure in the UK: a discrete choice experiment.

Author information

1
Nuffield Department of Primary Care Health Sciences, University of Oxford, and National Perinatal Epidemiology Unit (NPEU), Nuffield Department of Population Health, University of Oxford, Oxford.
2
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.
3
National Perinatal Epidemiology Unit (NPEU), Nuffield Department of Population Health, University of Oxford, Oxford.

Abstract

BACKGROUND:

With a variety of potentially effective hypertension management options, it is important to determine how patients value different models of care, and the relative importance of factors in their decision-making process.

AIM:

To explore patient preferences for the management of hypertension in the UK.

DESIGN AND SETTING:

Online survey of patients who have hypertension in the UK including an unlabelled discrete choice experiment (DCE).

METHOD:

A DCE was developed to assess patient preferences for the management of hypertension based on four attributes: model of care, frequency of blood pressure (BP) measurement, reduction in 5-year cardiovascular risk, and costs to the NHS. A mixed logit model was used to estimate preferences, willingness-to-pay was modelled, and a scenario analysis was conducted to evaluate the impact of changes in attribute levels on the uptake of different models of care.

RESULTS:

One hundred and sixty-seven participants completed the DCE (aged 61.4 years, 45.0% female, 82.0% >5 years since diagnosis). All four attributes were significant in choice (P<0.05). Reduction in 5-year cardiovascular risk was the main driver of patient preference as evidenced in the scenario and willingness-to-pay analyses. GP management was significantly preferred over self-management. Patients preferred scenarios with more frequent BP measurement, and lower costs to the NHS.

CONCLUSION:

Participants had similar preferences for GP management, pharmacist management, and telehealth, but a negative preference for self-management. When introducing new models of care for hypertension to patients, discussion of the potential benefits in terms of risk reduction should be prioritised to maximise uptake.

KEYWORDS:

general practice; hypertension; patient preference

PMID:
31405832
PMCID:
PMC6692085
DOI:
10.3399/bjgp19X705101
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for HighWire Icon for PubMed Central
Loading ...
Support Center