Towards patient-centered telerehabilitation design: understanding chronic pain patients' preferences of prospective telerehabilition treatments using a discrete choice experiment

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    Abstract

    Background: Patient-centered design that addresses patients’ preferences and needs is considered an important aim for improving health care systems. At present, within the field of pain rehabilitation, patients’ preferences regarding telerehabilitation remain scarcely explored and little is known about the optimal combination between human and electronic contact from the patients’perspective. In addition, limited evidence is available about the best way to explore patients’ preferences. Therefore, the assessment of patients’ preferences regarding telemedicine is an important step toward the design of effective patient-centered care. Objective: To identify which telerehabilitation treatment options patients with chronic pain are most likely to accept as alternatives to conventional rehabilitation and assess which treatment attributes are most important to them. Methods: A discrete choice experiment with 15 choice tasks, combining 6 telerehabilitation treatment characteristics, was designed. Each choice task consisted of 2 hypothetical treatment scenarios and 1 opt-out scenario. Relative attribute importance was estimated using a bivariate probit regression analysis. One hundred and thirty surveys were received, of which 104 were usable questionnaires; thus, resulting in a total of 1547 observations. Results: Physician communication mode, the use of feedback and monitoring technology (FMT), and exercise location were key drivers of patients’ treatment preferences (P<.001). Patients were willing to accept less frequent physician consultation offered mainly through video communication, provided that they were offered FMT and some face-to-face consultation and could exercise outside their home environment at flexible exercise hours. Home-based telerehabilitation scenarios with minimal physician supervision were the least preferred. A reduction in health care premiums would make these telerehabilitation scenarios as attractive as conventional clinic-based rehabilitation. Conclusions: “Intermediate‿ telerehabilitation treatments offering FMT, some face-to-face consulting, and a gym-based exercise location should be pursued as promising alternatives to conventional chronic pain rehabilitation. Further research is necessary to explore whether strategies other than health care premium reductions could also increase the value of home telerehabilitation treatment.
    Original languageEnglish
    Number of pages14
    JournalJournal of medical internet research
    Volume19
    Issue number1
    DOIs
    Publication statusPublished - 20 Jan 2017

    Fingerprint

    Patient Preference
    Chronic Pain
    Rehabilitation
    Exercise
    Technology
    Delivery of Health Care
    Physicians
    Therapeutics
    Referral and Consultation
    Communication
    Patient-Centered Care
    Telemedicine
    Telerehabilitation
    Regression Analysis
    Pain
    Research

    Keywords

    • EWI-27819
    • Tele-rehabilitation
    • patient acceptance of health care
    • patient compliance
    • patient preference
    • Decision support techniques
    • IR-104024
    • Chronic disease
    • Chronic pain
    • Exercise therapy
    • Decision Making
    • choice behavior

    Cite this

    @article{b5e513ce984f439b9e3027f730fa4667,
    title = "Towards patient-centered telerehabilitation design: understanding chronic pain patients' preferences of prospective telerehabilition treatments using a discrete choice experiment",
    abstract = "Background: Patient-centered design that addresses patients’ preferences and needs is considered an important aim for improving health care systems. At present, within the field of pain rehabilitation, patients’ preferences regarding telerehabilitation remain scarcely explored and little is known about the optimal combination between human and electronic contact from the patients’perspective. In addition, limited evidence is available about the best way to explore patients’ preferences. Therefore, the assessment of patients’ preferences regarding telemedicine is an important step toward the design of effective patient-centered care. Objective: To identify which telerehabilitation treatment options patients with chronic pain are most likely to accept as alternatives to conventional rehabilitation and assess which treatment attributes are most important to them. Methods: A discrete choice experiment with 15 choice tasks, combining 6 telerehabilitation treatment characteristics, was designed. Each choice task consisted of 2 hypothetical treatment scenarios and 1 opt-out scenario. Relative attribute importance was estimated using a bivariate probit regression analysis. One hundred and thirty surveys were received, of which 104 were usable questionnaires; thus, resulting in a total of 1547 observations. Results: Physician communication mode, the use of feedback and monitoring technology (FMT), and exercise location were key drivers of patients’ treatment preferences (P<.001). Patients were willing to accept less frequent physician consultation offered mainly through video communication, provided that they were offered FMT and some face-to-face consultation and could exercise outside their home environment at flexible exercise hours. Home-based telerehabilitation scenarios with minimal physician supervision were the least preferred. A reduction in health care premiums would make these telerehabilitation scenarios as attractive as conventional clinic-based rehabilitation. Conclusions: “Intermediate‿ telerehabilitation treatments offering FMT, some face-to-face consulting, and a gym-based exercise location should be pursued as promising alternatives to conventional chronic pain rehabilitation. Further research is necessary to explore whether strategies other than health care premium reductions could also increase the value of home telerehabilitation treatment.",
    keywords = "EWI-27819, Tele-rehabilitation, patient acceptance of health care, patient compliance, patient preference, Decision support techniques, IR-104024, Chronic disease, Chronic pain, Exercise therapy, Decision Making, choice behavior",
    author = "Karlijn Cranen and Groothuis-Oudshoorn, {Catharina Gerarda Maria} and Vollenbroek-Hutten, {Miriam Marie Ros{\'e}} and IJzerman, {Maarten Joost}",
    year = "2017",
    month = "1",
    day = "20",
    doi = "10.2196/jmir.5951",
    language = "English",
    volume = "19",
    journal = "Journal of medical internet research",
    issn = "1439-4456",
    publisher = "JMIR Publications",
    number = "1",

    }

    TY - JOUR

    T1 - Towards patient-centered telerehabilitation design: understanding chronic pain patients' preferences of prospective telerehabilition treatments using a discrete choice experiment

    AU - Cranen, Karlijn

    AU - Groothuis-Oudshoorn, Catharina Gerarda Maria

    AU - Vollenbroek-Hutten, Miriam Marie Rosé

    AU - IJzerman, Maarten Joost

    PY - 2017/1/20

    Y1 - 2017/1/20

    N2 - Background: Patient-centered design that addresses patients’ preferences and needs is considered an important aim for improving health care systems. At present, within the field of pain rehabilitation, patients’ preferences regarding telerehabilitation remain scarcely explored and little is known about the optimal combination between human and electronic contact from the patients’perspective. In addition, limited evidence is available about the best way to explore patients’ preferences. Therefore, the assessment of patients’ preferences regarding telemedicine is an important step toward the design of effective patient-centered care. Objective: To identify which telerehabilitation treatment options patients with chronic pain are most likely to accept as alternatives to conventional rehabilitation and assess which treatment attributes are most important to them. Methods: A discrete choice experiment with 15 choice tasks, combining 6 telerehabilitation treatment characteristics, was designed. Each choice task consisted of 2 hypothetical treatment scenarios and 1 opt-out scenario. Relative attribute importance was estimated using a bivariate probit regression analysis. One hundred and thirty surveys were received, of which 104 were usable questionnaires; thus, resulting in a total of 1547 observations. Results: Physician communication mode, the use of feedback and monitoring technology (FMT), and exercise location were key drivers of patients’ treatment preferences (P<.001). Patients were willing to accept less frequent physician consultation offered mainly through video communication, provided that they were offered FMT and some face-to-face consultation and could exercise outside their home environment at flexible exercise hours. Home-based telerehabilitation scenarios with minimal physician supervision were the least preferred. A reduction in health care premiums would make these telerehabilitation scenarios as attractive as conventional clinic-based rehabilitation. Conclusions: “Intermediate‿ telerehabilitation treatments offering FMT, some face-to-face consulting, and a gym-based exercise location should be pursued as promising alternatives to conventional chronic pain rehabilitation. Further research is necessary to explore whether strategies other than health care premium reductions could also increase the value of home telerehabilitation treatment.

    AB - Background: Patient-centered design that addresses patients’ preferences and needs is considered an important aim for improving health care systems. At present, within the field of pain rehabilitation, patients’ preferences regarding telerehabilitation remain scarcely explored and little is known about the optimal combination between human and electronic contact from the patients’perspective. In addition, limited evidence is available about the best way to explore patients’ preferences. Therefore, the assessment of patients’ preferences regarding telemedicine is an important step toward the design of effective patient-centered care. Objective: To identify which telerehabilitation treatment options patients with chronic pain are most likely to accept as alternatives to conventional rehabilitation and assess which treatment attributes are most important to them. Methods: A discrete choice experiment with 15 choice tasks, combining 6 telerehabilitation treatment characteristics, was designed. Each choice task consisted of 2 hypothetical treatment scenarios and 1 opt-out scenario. Relative attribute importance was estimated using a bivariate probit regression analysis. One hundred and thirty surveys were received, of which 104 were usable questionnaires; thus, resulting in a total of 1547 observations. Results: Physician communication mode, the use of feedback and monitoring technology (FMT), and exercise location were key drivers of patients’ treatment preferences (P<.001). Patients were willing to accept less frequent physician consultation offered mainly through video communication, provided that they were offered FMT and some face-to-face consultation and could exercise outside their home environment at flexible exercise hours. Home-based telerehabilitation scenarios with minimal physician supervision were the least preferred. A reduction in health care premiums would make these telerehabilitation scenarios as attractive as conventional clinic-based rehabilitation. Conclusions: “Intermediate‿ telerehabilitation treatments offering FMT, some face-to-face consulting, and a gym-based exercise location should be pursued as promising alternatives to conventional chronic pain rehabilitation. Further research is necessary to explore whether strategies other than health care premium reductions could also increase the value of home telerehabilitation treatment.

    KW - EWI-27819

    KW - Tele-rehabilitation

    KW - patient acceptance of health care

    KW - patient compliance

    KW - patient preference

    KW - Decision support techniques

    KW - IR-104024

    KW - Chronic disease

    KW - Chronic pain

    KW - Exercise therapy

    KW - Decision Making

    KW - choice behavior

    U2 - 10.2196/jmir.5951

    DO - 10.2196/jmir.5951

    M3 - Article

    VL - 19

    JO - Journal of medical internet research

    JF - Journal of medical internet research

    SN - 1439-4456

    IS - 1

    ER -