Larsen Lars Bruun, Thilsing Trine, Pedersen Line Bjørnskov
Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
Danish Centre for Health Economics-DaCHE, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
Fam Pract. 2020 Oct 19;37(5):689-694. doi: 10.1093/fampra/cmaa038.
Preventive health checks targeted at the at-risk population can be a way of preventing noncommunicable diseases. However, evidence on patient preferences for preventive health checks is limited, especially among patients with a high risk of noncommunicable diseases.
To examine patient preferences for preventive health checks in Danish general practice, targeting persons at high risk of a noncommunicable disease.
The method used in this study was a discrete choice experiment (DCE) with five attributes: assess, advice, agree, assist and arrange. The attributes were inspired by the 5A model for behaviour change counselling but was altered for the purpose of this study to grasp the entirety of the general practice-based intervention. Moreover, the attribute levels were defined to resemble daily clinical practice. The experimental design of the DCE was an efficient Bayesian main effects design and the results were analysed using a random utility theory framework.
A total of 148 patients completed the DCE. Patients at high risk of a noncommunicable disease have positive preferences for: giving brief explanations about own lifestyle, practicing shared decision-making with the general practitioner (GP), follow-up counselling with the GP after the preventive health check and scheduling a new appointment right after the preventive health check.
The results provide Danish GPs with evidence on their patients' preferences towards preventive health checks which will enable the GPs to tailor these consultations. Moreover, the results suggest that pre-appointment measures, such as a health profile, may mediate a preference for more action-oriented attributes.
Registered at Clinical Trial Gov (Unique Protocol ID: TOFpilot2016, https://clinicaltrials.gov/ct2/show/NCT02797392?term=TOFpilot2016&rank=1). Prospectively registered on the 29th of April 2016.
针对高危人群的预防性健康检查是预防非传染性疾病的一种方式。然而，关于患者对预防性健康检查偏好的证据有限，尤其是在非传染性疾病高危患者中。
研究丹麦全科医疗中针对非传染性疾病高危人群的预防性健康检查患者偏好。
本研究采用离散选择实验（DCE），有五个属性：评估、建议、同意、协助和安排。这些属性受行为改变咨询的5A模型启发，但为适用于本研究目的进行了调整，以涵盖基于全科医疗的干预整体情况。此外，属性水平的定义类似于日常临床实践。DCE的实验设计是一种高效的贝叶斯主效应设计，结果使用随机效用理论框架进行分析。
共有148名患者完成了DCE。非传染性疾病高危患者对以下方面有积极偏好：对自身生活方式进行简要解释、与全科医生（GP）进行共同决策、预防性健康检查后与GP进行随访咨询以及在预防性健康检查后立即安排新预约。
研究结果为丹麦全科医生提供了关于患者对预防性健康检查偏好的证据，这将使全科医生能够调整这些咨询服务。此外，结果表明预约前措施，如健康档案，可能会调节对更具行动导向性属性的偏好。
在Clinical Trial Gov注册（唯一协议标识符：TOFpilot2016，https://clinicaltrials.gov/ct2/show/NCT02797392?term=TOFpilot2016&rank=1）。于2016年4月29日进行前瞻性注册。
